Provider Demographics
NPI:1205516747
Name:JAVIER, RALEIGH VINYCE TENDENCIA (RN)
Entity type:Individual
Prefix:
First Name:RALEIGH VINYCE
Middle Name:TENDENCIA
Last Name:JAVIER
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 1:14106 2ND AVE W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6470
Mailing Address - Country:US
Mailing Address - Phone:714-928-4668
Mailing Address - Fax:
Practice Address - Street 1:14106 2ND AVE W
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6470
Practice Address - Country:US
Practice Address - Phone:714-928-4668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60931079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse