Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP30004503 | WA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP30004503 | WA |
NPI | 1245251164 |
---|---|
Provider Name | Mrs. Roberta Lynne Tuato'o |
First Address | Seattle, WA 98124-0366 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 31/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9626375 | (05) | WA |