Healthcare Provider Details

I. General information

NPI: 1811093859
Provider Name (Legal Business Name): TONYA POWELL REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

3316 MAIN AVE S
RENTON WA
98055-5769
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-1010
  • Fax: 206-768-5271
Mailing address:
  • Phone: 425-204-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN00130050
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: