Provider Demographics
NPI:1295236867
Name:HENRYALVAREZ, ROZETTE CASENE (LPN)
Entity type:Individual
Prefix:MS
First Name:ROZETTE
Middle Name:CASENE
Last Name:HENRYALVAREZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:ROZETTE
Other - Middle Name:CASENE
Other - Last Name:BYNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2602 WESTRIDGE AVE W APT Y201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1892
Mailing Address - Country:US
Mailing Address - Phone:253-882-4401
Mailing Address - Fax:866-360-5916
Practice Address - Street 1:2403 JONES AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4304
Practice Address - Country:US
Practice Address - Phone:206-290-7006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00057880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse