Provider Demographics
NPI:1578047163
Name:TSUMURA, EMI (RN)
Entity Type:Individual
Prefix:
First Name:EMI
Middle Name:
Last Name:TSUMURA
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 1:3319 NE 261ST AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9742
Mailing Address - Country:US
Mailing Address - Phone:360-909-3449
Mailing Address - Fax:
Practice Address - Street 1:3319 NE 261ST AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-9742
Practice Address - Country:US
Practice Address - Phone:360-909-3449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60020961163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse