Healthcare Provider Details

I. General information

NPI: 1871305805
Provider Name (Legal Business Name): APHRILL MOLINA ROMANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14815 PACIFIC AVE S
TACOMA WA
98444-4654
US

IV. Provider business mailing address

1617 E MAIN APT J107
PUYALLUP WA
98372-6787
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-8660
  • Fax:
Mailing address:
  • Phone: 386-243-1990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number61562487
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: