Provider Demographics
NPI:1568232338
Name:LOBBESTAEL, KAISA KAY (RN)
Entity Type:Individual
Prefix:
First Name:KAISA
Middle Name:KAY
Last Name:LOBBESTAEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAISA
Other - Middle Name:KAY
Other - Last Name:USKOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:16406 NE 193RD CT
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-3912
Mailing Address - Country:US
Mailing Address - Phone:360-798-4836
Mailing Address - Fax:
Practice Address - Street 1:3000 SE 164TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9314
Practice Address - Country:US
Practice Address - Phone:360-553-1350
Practice Address - Fax:360-233-4975
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00117426163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse