Provider Demographics
NPI:1447406442
Name:ALONSO, WILLIAM F
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:ALONSO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:F
Other - Last Name:ALONSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3580 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7915
Mailing Address - Country:US
Mailing Address - Phone:253-789-4500
Mailing Address - Fax:253-798-4255
Practice Address - Street 1:3580 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7915
Practice Address - Country:US
Practice Address - Phone:253-789-4500
Practice Address - Fax:253-798-4255
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANA00121383376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide