Provider Demographics
NPI:1285883850
Name:WAIHARO, ELSIE- RUTH W
Entity type:Individual
Prefix:MS
First Name:ELSIE- RUTH
Middle Name:W
Last Name:WAIHARO
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 1:10515 MOUNT TACOMA DR SW
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98498-1839
Mailing Address - Country:US
Mailing Address - Phone:253-414-7693
Mailing Address - Fax:
Practice Address - Street 1:10515 MOUNT TACOMA DR SW
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98498-1839
Practice Address - Country:US
Practice Address - Phone:253-414-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61073232163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse