Provider Demographics
NPI:1093810731
Name:KALINA, CAROL JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JO
Last Name:KALINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1476
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-4476
Mailing Address - Country:US
Mailing Address - Phone:206-764-2305
Mailing Address - Fax:206-764-2689
Practice Address - Street 1:1660 COLUMBIAN WAY SOUTH (S-111-DERM)
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1597
Practice Address - Country:US
Practice Address - Phone:206-764-2305
Practice Address - Fax:206-764-2689
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA83922163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care