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NPI Code Detail

MEDICARE: ALESSA L LOPEZ-CASTOR FNP-C

MEDICARE: ALESSA L LOPEZ-CASTOR FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP60420859WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NPWF1OTHERIDBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000010152176OTHERIDBLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285661744
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALESSA L LOPEZ-CASTOR FNP-C
Provider Business Mailing Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number : 360-716-2211
Provider Business Practice Location Address
First Line : 6330 31ST AVE NE STE 101
Second Line :
City : TULALIP
State : WA
Zip : 98271-7423
Country : US
Telephone Number : 360-716-2200
Fax Number : 360-716-2211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/18/2023

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Directions to “ ALESSA L LOPEZ-CASTOR FNP-C” Practice Location

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