Individual
MS. MARISSA AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2124 4TH AVE, SEATTLE, WA 98121-2308
(206) 512-6848
Mailing address
8608 24TH AVE SW, SEATTLE, WA 98106-2211
(206) 602-7494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00114779
WA
171M00000X
Case Manager/Care Coordinator
RN00114779
WA
Other
Enumeration date
05/18/2017
Last updated
05/18/2017
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