Provider Demographics
NPI:1245665207
Name:DUSTERHOFT, DELORES HELEN (RN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:DELORES
Middle Name:HELEN
Last Name:DUSTERHOFT
Suffix:
Gender:F
Credentials:RN (REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 165TH ST NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-6729
Mailing Address - Country:US
Mailing Address - Phone:360-652-1778
Mailing Address - Fax:
Practice Address - Street 1:7525 165TH ST NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6729
Practice Address - Country:US
Practice Address - Phone:360-652-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00089514163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse