Individual provider · Type 1 NPI

Deziaray Mata Butler

Licensed Practical Nurse · Tacoma, WA

NPI number 1053221853 Active

Practice location

9040 Jackson Ave
Tacoma, WA 98431-0001

Call (253) 968-3105 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X1168804 (TX)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1053221853

Deziaray Mata Butler's National Provider Identifier is 1053221853, issued on Sep 11, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Tacoma, WA. The record was last updated on Sep 11, 2026.