Provider Demographics
NPI:1710213558
Name:LEJAMEYER, KATHLEEN R (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:LEJAMEYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 N HUTCHINSON RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2444
Mailing Address - Country:US
Mailing Address - Phone:509-456-7414
Mailing Address - Fax:509-624-0763
Practice Address - Street 1:1807 N HUTCHINSON RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2444
Practice Address - Country:US
Practice Address - Phone:509-456-7414
Practice Address - Fax:509-624-0763
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60105177363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner