Healthcare Provider Details

I. General information

NPI: 1518838093
Provider Name (Legal Business Name): NURY I. QUEVEDO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16609 E DESMET CT APT D304
SPOKANE VALLEY WA
99216-3559
US

IV. Provider business mailing address

16609 E DESMET CT APT D304
SPOKANE VALLEY WA
99216-3559
US

V. Phone/Fax

Practice location:
  • Phone: 509-210-2711
  • Fax:
Mailing address:
  • Phone: 509-210-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP-CNP45470
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number45470
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70075966-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: