Provider Demographics
NPI:1255069530
Name:DELO, DANETTE LOUISE (DNP-PMHNP)
Entity type:Individual
Prefix:MS
First Name:DANETTE
Middle Name:LOUISE
Last Name:DELO
Suffix:
Gender:F
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 261ST AVE E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-9190
Mailing Address - Country:US
Mailing Address - Phone:253-606-2499
Mailing Address - Fax:
Practice Address - Street 1:12202 261ST AVE E
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-9190
Practice Address - Country:US
Practice Address - Phone:253-606-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61341263363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health