Provider Demographics
NPI:1609640127
Name:CAMERON, DEANN ANNETTE
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:ANNETTE
Last Name:CAMERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20951 FRANCIS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-8497
Mailing Address - Country:US
Mailing Address - Phone:360-595-3408
Mailing Address - Fax:
Practice Address - Street 1:20951 FRANCIS RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-8497
Practice Address - Country:US
Practice Address - Phone:360-595-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00050485164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse