Provider Demographics
NPI:1750046157
Name:ENGELHARDT-PARALES, MARIA JELYN B (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIA JELYN
Middle Name:B
Last Name:ENGELHARDT-PARALES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 PACIFIC AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7836
Mailing Address - Country:US
Mailing Address - Phone:253-474-7719
Mailing Address - Fax:
Practice Address - Street 1:3716 PACIFIC AVE STE D
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7836
Practice Address - Country:US
Practice Address - Phone:253-474-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60244982163W00000X
WA2021085251163WP0809X
WA61165549363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult