Healthcare Provider Details

I. General information

NPI: 1235695453
Provider Name (Legal Business Name): DEBORAH KAYE HUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E MIDWAY RD
COLBERT WA
99005-9206
US

IV. Provider business mailing address

227 E MIDWAY RD
COLBERT WA
99005-9206
US

V. Phone/Fax

Practice location:
  • Phone: 509-443-5033
  • Fax: 509-443-5025
Mailing address:
  • Phone: 509-443-5033
  • Fax: 509-443-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number602480984
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: