Cascade Dermatology Plus LLC
Nurse Practitioner in Ellensburg, WA. Organization (NPI-2).
NPI number1255106969
StatusActive
Last updated in NPPESDec 2, 2023
Details
- NPI
- 1255106969
- Entity type
- Organization (NPI-2)
- Legal business name
- Cascade Dermatology Plus LLC
- Organization subpart
- No
- Enumeration date
- Nov 22, 2023
- Certification date
- Dec 2, 2023
- Last updated
- Dec 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
700 E Mountain View Ave Ste 503Ellensburg, WA 98926-4802
Phone 509-306-9175
Mailing address
780 Harold RdEllensburg, WA 98926-8688
Phone 509-306-9175
Authorized official
Karen C Ely
Nurse Practitioner
5093069175
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