Basic Information
Provider Information
NPI: 1669014973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: ARLENE
MiddleName: JOSEPHINE
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 413 LILY RD NE
Address2:  
City: OLYMPIA
State: WA
PostalCode: 98506
CountryCode: US
TelephoneNumber: 3604937060
FaxNumber: 3604937562
Practice Location
Address1: 413 LILY RD NE
Address2:  
City: OLYMPIA
State: WA
PostalCode: 98506
CountryCode: US
TelephoneNumber: 3604937060
FaxNumber: 3604937562
Other Information
ProviderEnumerationDate: 10/09/2019
LastUpdateDate: 10/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN00089582WAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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