Provider Demographics
NPI:1760192710
Name:WESSEL, KATY DAWN (RN)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:DAWN
Last Name:WESSEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:DAWN
Other - Last Name:GOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0410
Mailing Address - Country:US
Mailing Address - Phone:360-645-2233
Mailing Address - Fax:360-645-2723
Practice Address - Street 1:250 FORT ST
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357-4003
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:360-645-2723
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN1352539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse