Provider Demographics
NPI:1831464262
Name:YOUNG, ROSA DELL (RN)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:DELL
Last Name:YOUNG
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:PO BOX 18938
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-0938
Mailing Address - Country:US
Mailing Address - Phone:206-723-8154
Mailing Address - Fax:
Practice Address - Street 1:15 S GRADY WAY STE 533
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3217
Practice Address - Country:US
Practice Address - Phone:206-722-4936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA250-00-0049581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse