Provider Demographics
NPI:1508634825
Name:RICE, KEVIN (RN)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10526 SW BURTON DR
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7086
Mailing Address - Country:US
Mailing Address - Phone:206-551-9991
Mailing Address - Fax:
Practice Address - Street 1:1701 18TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4317
Practice Address - Country:US
Practice Address - Phone:206-731-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60454987163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice