Provider Demographics
NPI:1689141913
Name:TUBERA, AILEEN ALARCIO (LICENSED NURSE)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:ALARCIO
Last Name:TUBERA
Suffix:
Gender:F
Credentials:LICENSED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 S DONOVAN ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4837
Mailing Address - Country:US
Mailing Address - Phone:206-604-6554
Mailing Address - Fax:
Practice Address - Street 1:2133 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2385
Practice Address - Country:US
Practice Address - Phone:206-223-3644
Practice Address - Fax:206-223-1482
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60447567164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse