Provider Demographics
NPI:1740246602
Name:MORRELL, JANINE R (MN)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:R
Last Name:MORRELL
Suffix:
Gender:F
Credentials:MN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MLK JR WAY
Mailing Address - Street 2:MS Z0 NTL
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98505
Mailing Address - Country:US
Mailing Address - Phone:253-403-1019
Mailing Address - Fax:
Practice Address - Street 1:315 MLK JR WAY
Practice Address - Street 2:MS Z0 NTL
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98505
Practice Address - Country:US
Practice Address - Phone:253-403-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004601363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care