Healthcare Provider Details

I. General information

NPI: 1285547612
Provider Name (Legal Business Name): LILIANA MICHELLE GUTIERREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST MAIN HOSPITAL
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

103 N LAKE BLVD
PLANT CITY FL
33563-4514
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3300
  • Fax:
Mailing address:
  • Phone: 813-471-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN61043188
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: