Provider Demographics
NPI:1720674948
Name:AUZENNE, CIERA MICHELLE
Entity Type:Individual
Prefix:
First Name:CIERA
Middle Name:MICHELLE
Last Name:AUZENNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 HAMPTON DR SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6258
Mailing Address - Country:US
Mailing Address - Phone:360-789-3365
Mailing Address - Fax:
Practice Address - Street 1:6700 MARTIN WAY E STE 117
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-5586
Practice Address - Country:US
Practice Address - Phone:360-413-6910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician