Healthcare Provider Details

I. General information

NPI: 1184453375
Provider Name (Legal Business Name): FLORENTINO RODNEY FRANCISCO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 RAINIER AVE S
SEATTLE WA
98144-2838
US

IV. Provider business mailing address

29105 23RD AVE S
FEDERAL WAY WA
98003-7924
US

V. Phone/Fax

Practice location:
  • Phone: 206-293-4953
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: