Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP30007753 | WA |
NPI | 1013347194 |
---|---|
Provider Name | Kay Frey |
First Address | Vashon, WA 98070-5234 |
Second Address | Vashon, WA 98070-5234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2013 |
Last Update Date | 26/11/2013 |