Healthcare Provider Details

I. General information

NPI: 1093826844
Provider Name (Legal Business Name): PAUL PATRICK SPATARO A.R.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 VETERANS DR SW
TACOMA WA
98493-0003
US

IV. Provider business mailing address

VA PUGET SOUND HEALTH CARE SYSTEM-AMERICAN LAKE DIV 9600 S. VETERANS DR
TACOMA WA
98493-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8440
  • Fax: 253-589-4136
Mailing address:
  • Phone: 253-582-8440
  • Fax: 253-589-4136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberAP30003067
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: