Healthcare Provider Details

I. General information

NPI: 1275437345
Provider Name (Legal Business Name): KAITLYN M HUDDLESTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E ROWAN AVE STE 102
SPOKANE WA
99207-1240
US

IV. Provider business mailing address

529 W 3RD ST
NEWPORT WA
99156-9082
US

V. Phone/Fax

Practice location:
  • Phone: 509-489-2101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60754037
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: