Provider Demographics
NPI:1285481036
Name:GRANDE, FRANCISCA TAMAYO
Entity type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:TAMAYO
Last Name:GRANDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 141ST ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4582
Mailing Address - Country:US
Mailing Address - Phone:253-414-5803
Mailing Address - Fax:
Practice Address - Street 1:815 S VASSAULT ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-2008
Practice Address - Country:US
Practice Address - Phone:253-444-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61521933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily