Healthcare Provider Details

I. General information

NPI: 1164729729
Provider Name (Legal Business Name): CALLY MCKEMIE DINGLER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CALLY MCKEMIE CLAUSSEN

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 CAPITOL WAY S STE 201
OLYMPIA WA
98501-1210
US

IV. Provider business mailing address

924 CAPITOL WAY S STE 201
OLYMPIA WA
98501-1210
US

V. Phone/Fax

Practice location:
  • Phone: 360-495-1604
  • Fax: 360-282-1201
Mailing address:
  • Phone: 360-495-1604
  • Fax: 360-282-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number716790
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP119996
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP119996
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: