1295236867 NPI number — MS. ROZETTE CASENE HENRYALVAREZ LPN

Table of content: MS. ROZETTE CASENE HENRYALVAREZ LPN (NPI 1295236867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295236867 NPI number — MS. ROZETTE CASENE HENRYALVAREZ LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HENRYALVAREZ
Provider First Name:
ROZETTE
Provider Middle Name:
CASENE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BYNUM
Provider Other First Name:
ROZETTE
Provider Other Middle Name:
CASENE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295236867
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2602 WESTRIDGE AVE W APT Y201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98466-1892
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-882-4401
Provider Business Mailing Address Fax Number:
866-360-5916

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2403 JONES AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98055-4304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-290-7006
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  LP00057880 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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