MEDICARE: THERESE MOLINA ALLEN R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN60216418	WA

General Provider Information

NPI Number	:	1700240033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE MOLINA ALLEN R.N.

Provider Business Mailing Address
First Line	:	1217 V ST NW
Second Line	:
City	:	AUBURN
State	:	WA
Zip	:	98001-3514
Country	:	US
Telephone Number	:	206-462-8385
Fax Number	:

Provider Business Practice Location Address
First Line	:	22207 7TH AVE S STE A
Second Line	:
City	:	DES MOINES
State	:	WA
Zip	:	98198-6221
Country	:	US
Telephone Number	:	206-414-9979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	03/27/2021

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