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General NPI Number Information
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NPI Number | 1447702444
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Entity Type | Individual
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Provider Name | JOANE MHARETTE CASALLO-DALIT LP60221107
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Gender | Female
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 1116 SUMMIT AVE
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City | SEATTLE
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State | WA
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Zip | 98101-2831
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Country | US
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Telephone | 206-323-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 MAIN AVE S
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City | RENTON
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State | WA
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Zip | 98055-5792
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Country | US
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Telephone | 253-632-0367
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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 | LP60221107
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License Number State | WA
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