Basic Information
| Provider Information | |||||||||
| NPI: | 1770689507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARRASCO | ||||||||
| FirstName: | ABBIE | ||||||||
| MiddleName: | ALANE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | REGISTERED NURSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4610 E MAPLE LANE CIR NW | ||||||||
| Address2: | |||||||||
| City: | GIG HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983358135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535828440 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | AMERICAN LAKE VAMC | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984930001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535828440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WA0400X | RC00026641 | WA | Y | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) |
No ID Information.