Provider Demographics
NPI:1407408545
Name:ROMAINE, ALISON LEE (RN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:LEE
Last Name:ROMAINE
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 1:41 E EMERALD LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:GRAPEVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98546-9714
Mailing Address - Country:US
Mailing Address - Phone:414-379-4622
Mailing Address - Fax:
Practice Address - Street 1:41 E EMERALD LAKE DR E
Practice Address - Street 2:
Practice Address - City:GRAPEVIEW
Practice Address - State:WA
Practice Address - Zip Code:98546-9714
Practice Address - Country:US
Practice Address - Phone:414-379-4622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60275102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse