Provider Demographics
NPI:1205386919
Name:VENEZIA, LIANE M (RN)
Entity type:Individual
Prefix:MRS
First Name:LIANE
Middle Name:M
Last Name:VENEZIA
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 1:9018 BRINKLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-5071
Mailing Address - Country:US
Mailing Address - Phone:803-403-4083
Mailing Address - Fax:
Practice Address - Street 1:9200 RAILROAD AVE SE
Practice Address - Street 2:MOUNT SI HIGH SCHOOL
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9640
Practice Address - Country:US
Practice Address - Phone:425-831-8481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60546918163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse