Provider Demographics
NPI:1235608134
Name:ORBE- BARRAGAN, ADILENNE
Entity Type:Individual
Prefix:
First Name:ADILENNE
Middle Name:
Last Name:ORBE- BARRAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 E G ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-2046
Mailing Address - Country:US
Mailing Address - Phone:253-353-9634
Mailing Address - Fax:
Practice Address - Street 1:7610 40TH ST W STE 300
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-3834
Practice Address - Country:US
Practice Address - Phone:253-355-1807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator