Healthcare Provider Details

I. General information

NPI: 1720164817
Provider Name (Legal Business Name): MARIA FE G LAZARTE RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAYE LAZARTE RN, BSN

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
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

2683 ARNOLD ST
DUPONT WA
98327-8716
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8440
  • Fax:
Mailing address:
  • Phone: 253-964-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN00164032
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: