Provider Demographics
NPI:1225674575
Name:CAMILLONI, LORELEI (RN)
Entity Type:Individual
Prefix:
First Name:LORELEI
Middle Name:
Last Name:CAMILLONI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LORELEI
Other - Middle Name:
Other - Last Name:BATARAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13242 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-3304
Mailing Address - Country:US
Mailing Address - Phone:206-669-6100
Mailing Address - Fax:
Practice Address - Street 1:13242 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98146-3304
Practice Address - Country:US
Practice Address - Phone:206-669-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00163492163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse