Healthcare Provider Details

I. General information

NPI: 1184587974
Provider Name (Legal Business Name): TINA MARIE SPRINGER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

IV. Provider business mailing address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

V. Phone/Fax

Practice location:
  • Phone: 360-330-9595
  • Fax: 360-330-9530
Mailing address:
  • Phone: 360-330-9595
  • Fax: 360-330-9530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN70047075
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: