Healthcare Provider Details

I. General information

NPI: 1669856316
Provider Name (Legal Business Name): NABETSE TAPIA MS, FNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 AUBURN AVE SUITE 300
AUBURN WA
98002-5057
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 253-735-0166
  • Fax: 253-833-8987
Mailing address:
  • Phone: 253-735-0166
  • Fax: 253-833-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60650391
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number689238
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60623276
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: