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General NPI Number Information
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NPI Number | 1568900637
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Entity Type | Individual
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Provider Name | MONICA CHAVEZ RN
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Gender | Female
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-968-3869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7554
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City | BONNEY LAKE
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State | WA
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Zip | 98391-0951
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Country | US
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Telephone | 559-862-7425
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60559884
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License Number State | WA
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