Healthcare Provider Details

I. General information

NPI: 1528631066
Provider Name (Legal Business Name): QUESHA KATHLEEN FOSTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 LILLY RD NE
OLYMPIA WA
98506-5028
US

IV. Provider business mailing address

2602 HALCYON AVE NW
OLYMPIA WA
98502-3016
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-8880
  • Fax: 360-810-3697
Mailing address:
  • Phone: 404-202-3407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN255164
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN255164
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61208460
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: