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General NPI Number Information
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NPI Number | 1144120841
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Entity Type | Individual
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Provider Name | CALLIE NOELLE DEKRUYF
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Gender | Female
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 502 W 4TH AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1616
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Country | US
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Telephone | 509-865-1694
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Fax |
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Provider Business Mailing Address
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Address Line | 2378 HIGHWAY 142
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City | GOLDENDALE
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State | WA
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Zip | 98620-3012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 70151289
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License Number State | WA
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