Basic Information
| Provider Information | |||||||||
| NPI: | 1811297401 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELY | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | FNP, ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9787 | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989090787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095748255 | ||||||||
| FaxNumber: | 5092253168 | ||||||||
| Practice Location | |||||||||
| Address1: | 2811 TIETON DR | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989023761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095758100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2010 | ||||||||
| LastUpdateDate: | 01/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WE0003X | RN000144555 | WA | N | Nursing Service Providers | Registered Nurse | Emergency | 363LF0000X | AP60196761 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LA2100X | AP60196761 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.