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General NPI Number Information
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NPI Number | 1114463403
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Entity Type | Individual
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Provider Name | CELIANA TUPUA LPN
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Gender | Female
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER,
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City | TACOMA
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State | WA
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Zip | 98413-1100
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Country | US
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Telephone | 360-968-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 15312 CARTER CT SE
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City | YELM
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State | WA
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Zip | 98597-8575
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Country | US
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Telephone | 253-683-0103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP60687182
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61050233
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License Number State | WA
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