MEDICARE: MRS. DENISE MARIE HALASZ ARNP

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	363L00000X	Nurse Practitioner	AP30006956	WA
2	363L00000X	Nurse Practitioner	RN00158414	WA

General Provider Information

NPI Number	:	1841296886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISE MARIE HALASZ ARNP

Provider Business Mailing Address
First Line	:	2310 CLARK RD
Second Line	:
City	:	FORT LEWIS
State	:	WA
Zip	:	98433-1041
Country	:	US
Telephone Number	:	253-962-2736
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 A FITZSIMMONS AVE.
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0001
Country	:	US
Telephone Number	:	253-967-9594
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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