Provider Demographics
NPI:1710474101
Name:MARQUINEZ, QUEENIE (RN)
Entity Type:Individual
Prefix:
First Name:QUEENIE
Middle Name:
Last Name:MARQUINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 65TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-2350
Mailing Address - Country:US
Mailing Address - Phone:253-249-5757
Mailing Address - Fax:
Practice Address - Street 1:4233 65TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-2350
Practice Address - Country:US
Practice Address - Phone:253-249-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60427250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse