Healthcare Provider Details

I. General information

NPI: 1508203886
Provider Name (Legal Business Name): JANICE EILENE DOYLE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 176TH ST E
SPANAWAY WA
98387-8335
US

IV. Provider business mailing address

1321 BEL AIR RD
TACOMA WA
98406-2106
US

V. Phone/Fax

Practice location:
  • Phone: 253-683-6940
  • Fax:
Mailing address:
  • Phone: 253-267-5044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN00045249
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: