Healthcare Provider Details

I. General information

NPI: 1154858389
Provider Name (Legal Business Name): MARIA ISABEL RODRIGUEZ PEREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 05/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 100TH ST SE STE B
EVERETT WA
98208-3832
US

IV. Provider business mailing address

12519 212TH ST NE
ARLINGTON WA
98223-6921
US

V. Phone/Fax

Practice location:
  • Phone: 425-312-0204
  • Fax:
Mailing address:
  • Phone: 360-631-3188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60272879
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: