MEDICARE: MS. GERILYN TOLENTINO CORPUZ RN

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
1	163WX0200X	Oncology Registered Nurse	RN00163488	WA

General Provider Information

NPI Number	:	1538260708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GERILYN TOLENTINO CORPUZ RN

Provider Business Mailing Address
First Line	:	10011 BRIDGEPORT WAY SW STE 1500
Second Line	:	PMB #289
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2332
Country	:	US
Telephone Number	:	425-442-1155
Fax Number	:

Provider Business Practice Location Address
First Line	:	10011 BRIDGEPORT WAY SW STE 1500
Second Line	:	PMB #289
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2332
Country	:	US
Telephone Number	:	425-442-1155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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