Healthcare Provider Details

I. General information

NPI: 1386435071
Provider Name (Legal Business Name): KALEY JANE WYPYSZYNSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SW ALASKA ST STE B
SEATTLE WA
98116-4527
US

IV. Provider business mailing address

4117 SW HOLLY ST
SEATTLE WA
98136-1823
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-3399
  • Fax:
Mailing address:
  • Phone: 952-215-5871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70006828-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: