Provider Demographics
NPI:1295277325
Name:SILVA, COLLEEN M (LPN)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:M
Last Name:SILVA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:M
Other - Last Name:KROFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:7216 66TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8327
Mailing Address - Country:US
Mailing Address - Phone:253-983-0959
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
Practice Address - Street 2:MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98341-1100
Practice Address - Country:US
Practice Address - Phone:253-651-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00046178164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse