Healthcare Provider Details

I. General information

NPI: 1336061886
Provider Name (Legal Business Name): DIANIE E TOTAAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 S 355TH PL
FEDERAL WAY WA
98003-9144
US

IV. Provider business mailing address

2524 S 355TH PL
FEDERAL WAY WA
98003-9144
US

V. Phone/Fax

Practice location:
  • Phone: 206-852-3004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number61348456
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: