Individual provider · Type 1 NPI

Revonna Shantay King

Licensed Practical Nurse · Seattle, WA

NPI number 1174485874 Active

Practice location

2212 S Jackson St
Seattle, WA 98144-2591

Call (206) 322-2387 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XLP00036735 (WA)

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 1174485874

Revonna Shantay King's National Provider Identifier is 1174485874, issued on Dec 1, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Seattle, WA. The record was last updated on Dec 1, 2025.