Provider Demographics
NPI:1669644985
Name:IONESCU, PETRONELA
Entity Type:Individual
Prefix:MRS
First Name:PETRONELA
Middle Name:
Last Name:IONESCU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30846 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7803
Mailing Address - Country:US
Mailing Address - Phone:253-838-4629
Mailing Address - Fax:253-838-4629
Practice Address - Street 1:30846 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7803
Practice Address - Country:US
Practice Address - Phone:253-838-4629
Practice Address - Fax:253-838-4629
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA495400311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home