Provider Demographics
NPI:1558607416
Name:CHELLINO, CAROL A (RN)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:CHELLINO
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 1:2445 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134-1923
Mailing Address - Country:US
Mailing Address - Phone:206-252-0750
Mailing Address - Fax:206-252-0751
Practice Address - Street 1:8311 BEACON AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4323
Practice Address - Country:US
Practice Address - Phone:206-252-7500
Practice Address - Fax:206-743-3180
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00067031163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool