Denice C Acheson, LPN

Individual provider Active NPI Licensed Practical Nurse · Chehalis, WA

NPI 1417580010 · NPPES record last updated Feb 21, 2020

Key facts

NPI
1417580010
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LP00036269 (WA)
Practice address
500 SE Washington Ave
Chehalis, WA 98532-3058
Phone
(360) 748-4776
NPI assigned
Feb 21, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LP00036269WAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00036269 WA Yes

Addresses

Primary practice location

500 SE Washington Ave
Chehalis, WA 98532-3058

Mailing address

500 SE Washington Ave
Chehalis, WA 98532-3058
Phone (360) 748-4776

Other identifiers

IdentifierTypeStateIssuer
2077844MedicaidWA

Other providers in Chehalis, WA

All providers in Chehalis, WA · Licensed Practical Nurse in Washington

Sources for this page

Verify at the official NPI Registry.