Provider Demographics
NPI:1780151530
Name:MALINIS-ROSATI, CLAIRECE (HEALTH EDUCATOR)
Entity type:Individual
Prefix:
First Name:CLAIRECE
Middle Name:
Last Name:MALINIS-ROSATI
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1477
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-0312
Mailing Address - Country:US
Mailing Address - Phone:509-897-2824
Mailing Address - Fax:509-897-5758
Practice Address - Street 1:401 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2846
Practice Address - Country:US
Practice Address - Phone:509-897-2824
Practice Address - Fax:509-897-2822
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator