Provider Demographics
NPI:1518746700
Name:BANALES, DENISE ROXANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ROXANNE
Last Name:BANALES
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 1:7855 BEARDSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8380
Mailing Address - Country:US
Mailing Address - Phone:253-677-3770
Mailing Address - Fax:
Practice Address - Street 1:7855 BEARDSLEY AVE
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8380
Practice Address - Country:US
Practice Address - Phone:253-677-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00167425163WN0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk