Provider Demographics
NPI:1245251164
Name:TUATO'O, ROBERTA LYNNE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:LYNNE
Last Name:TUATO'O
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:LYNNE
Other - Last Name:MCMULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 24366
Mailing Address - Street 2:M/S 359107
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0366
Mailing Address - Country:US
Mailing Address - Phone:206-598-8920
Mailing Address - Fax:206-598-7663
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:BOX 359300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2394
Practice Address - Fax:206-987-2685
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00096083163W00000X
WAAP30004503363L00000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9626375Medicaid