Provider Demographics
NPI:1699029033
Name:TANG, KAILA ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAILA
Middle Name:ROSE
Last Name:TANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KAILA
Other - Middle Name:ROSE
Other - Last Name:STAUB-DELONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13030 MILITARY RD S STE 108
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3079
Mailing Address - Country:US
Mailing Address - Phone:206-242-0885
Mailing Address - Fax:
Practice Address - Street 1:13030 MILITARY RD S STE 108
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3079
Practice Address - Country:US
Practice Address - Phone:206-242-0885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60088951163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN60088951OtherREGISTERED NURSE LICENSE