Provider Demographics
NPI:1932564093
Name:LLAMAS, DARLA (LP00057026)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:LLAMAS
Suffix:
Gender:F
Credentials:LP00057026
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 199TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-5646
Mailing Address - Country:US
Mailing Address - Phone:253-847-3787
Mailing Address - Fax:253-847-3787
Practice Address - Street 1:610 YAKIMA AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4851
Practice Address - Country:US
Practice Address - Phone:253-396-5246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP 00057026164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse