Provider Demographics
NPI:1609503226
Name:ALANIS, ROBERTO JONATHAN (ARNP-CS)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:JONATHAN
Last Name:ALANIS
Suffix:
Gender:M
Credentials:ARNP-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10503 SW 228TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7065
Mailing Address - Country:US
Mailing Address - Phone:312-622-2603
Mailing Address - Fax:
Practice Address - Street 1:10503 SW 228TH ST
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-7065
Practice Address - Country:US
Practice Address - Phone:312-622-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61132355364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics