Healthcare Provider Details

I. General information

NPI: 1942624291
Provider Name (Legal Business Name): ASHLEY NICOLE DESCAMP LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date: 05/09/2025
Reactivation Date: 10/09/2026

III. Provider practice location address

8033 W GRANDRIDGE BLVD
KENNEWICK WA
99336-7159
US

IV. Provider business mailing address

8033 W GRANDRIDGE BLVD STE C
KENNEWICK WA
99336-7159
US

V. Phone/Fax

Practice location:
  • Phone: 509-783-2225
  • Fax: 509-783-1898
Mailing address:
  • Phone: 509-783-2225
  • Fax: 509-783-1898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA60313599
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: