Provider Demographics
NPI:1619411295
Name:ELIGINO, JANETTE MIAGAN (RN)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:MIAGAN
Last Name:ELIGINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANETTE
Other - Middle Name:GELLADA
Other - Last Name:MIAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1133 TTEREVE DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-5101
Mailing Address - Country:US
Mailing Address - Phone:716-280-1536
Mailing Address - Fax:425-512-8598
Practice Address - Street 1:1133 TTEREVE DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5101
Practice Address - Country:US
Practice Address - Phone:716-280-1536
Practice Address - Fax:425-512-8598
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00172530163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse