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General NPI Number Information
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NPI Number | 1457795957
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Entity Type | Individual
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Provider Name | ANA AMPARO PENAS VASQUEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 2505 SOUTH 38TH ST BLDG A SUITE 109
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City | TACOMA
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State | WA
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Zip | 98409
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Country | US
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Telephone | 253-274-3943
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 TROON AVE SW
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City | PORT ORCHARD
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State | WA
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Zip | 98367-9187
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Country | US
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Telephone | 360-876-2120
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | AP60084656
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License Number State | WA
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