Healthcare Provider Details

I. General information

NPI: 1598640427
Provider Name (Legal Business Name): WANDA CHENEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 VETERANS DR SW
TACOMA WA
98493-0003
US

IV. Provider business mailing address

9600 VETERANS DR SW
TACOMA WA
98493-0003
US

V. Phone/Fax

Practice location:
  • Phone: 253-583-1234
  • Fax:
Mailing address:
  • Phone: 253-583-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN00098022
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: