Provider Demographics
NPI:1346638152
Name:CORPUZ, NATIVIDAD ALVIZ (RN)
Entity Type:Individual
Prefix:
First Name:NATIVIDAD
Middle Name:ALVIZ
Last Name:CORPUZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 163RD PL SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-4733
Mailing Address - Country:US
Mailing Address - Phone:206-372-2563
Mailing Address - Fax:
Practice Address - Street 1:4932 163RD PL SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-4733
Practice Address - Country:US
Practice Address - Phone:206-372-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00057686163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA936049Medicaid
WA504085Medicaid