Provider Demographics
NPI:1780011262
Name:SKINNER, JUNE ELIZABETH (CNA)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:ELIZABETH
Last Name:SKINNER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98858
Mailing Address - Country:US
Mailing Address - Phone:509-745-9010
Mailing Address - Fax:509-745-9010
Practice Address - Street 1:306 SOUTH CENTRAL
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:WA
Practice Address - Zip Code:98858
Practice Address - Country:US
Practice Address - Phone:509-745-9010
Practice Address - Fax:509-745-9010
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA752355376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide