Provider Demographics
NPI:1003440231
Name:TANJO, SELMA (DNP, ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SELMA
Middle Name:
Last Name:TANJO
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-BC
Other - Prefix:
Other - First Name:SELMA
Other - Middle Name:
Other - Last Name:TANJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, ARNP, FNP-BC
Mailing Address - Street 1:19507 HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5236
Mailing Address - Country:US
Mailing Address - Phone:425-353-7687
Mailing Address - Fax:
Practice Address - Street 1:19507 HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5236
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60655169163WC0200X
WAAP61193990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine