Provider Demographics
NPI:1851162622
Name:UBAS, CONSUELO THERESA ADLAWAN (RN)
Entity Type:Individual
Prefix:
First Name:CONSUELO THERESA
Middle Name:ADLAWAN
Last Name:UBAS
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 1:8715 NE 110TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-1233
Mailing Address - Country:US
Mailing Address - Phone:360-241-5289
Mailing Address - Fax:
Practice Address - Street 1:8715 NE 110TH CIR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-1233
Practice Address - Country:US
Practice Address - Phone:360-241-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61344822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse