Provider Demographics
NPI:1699400846
Name:CHANDLER-PIETERS, LORI ANN (LPN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:CHANDLER-PIETERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3100
Mailing Address - Country:US
Mailing Address - Phone:508-895-7340
Mailing Address - Fax:509-895-7344
Practice Address - Street 1:307 S 12TH AVE STE 12
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3143
Practice Address - Country:US
Practice Address - Phone:508-895-7340
Practice Address - Fax:509-895-7344
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60274250164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse