Active NPI
Kelly Deweese, RN
- Pain Management Registered Nurse
- Olympia, WA
National Provider Identifier
1144984154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Management Registered Nurse
- License
- RN60283693
- Practice address
- 205 Lilly Rd NE Ste B
Olympia, WA 98506-5070 - Phone
- (360) 489-1558
- Fax
- (360) 688-1066
- NPI assigned
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | RN60283693 | WA | Primary |
Addresses
Primary practice location
205 Lilly Rd NE Ste B
Olympia, WA 98506-5070
Mailing address
311 E Way to Tipperary St
Shelton, WA 98584-7526
Phone (360) 350-8351
Other practice location 1
1702 4th Ave E
Olympia, WA 98506-4534
Phone (360) 350-8351
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | kdeweese360@gmail.com | Health Information Exchange (HIE) | Rejuvenate IV Hydration and Wellness Center |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60283693 | WA | MD | Pain Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1144984154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 E WAY TO TIPPERARY ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985847526",
"telephone_number": "360-350-8351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 LILLY RD NE STE B",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065070",
"telephone_number": "360-489-1558",
"fax_number": "360-688-1066"
}
],
"practiceLocations": [
{
"address_1": "1702 4th Ave E",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985064534",
"country_code": "US",
"telephone_number": "360-350-8351",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEWEESE",
"first_name": "KELLY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pain Management",
"state": "WA",
"license": "RN60283693",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "kdeweese360@gmail.com",
"affiliation": "Y",
"endpointDescription": "business email",
"affiliationName": "Rejuvenate IV Hydration and Wellness Center",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Health History",
"address_1": "205 Lilly Rd NE Ste B",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065070",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.