Provider Demographics
NPI:1316760374
Name:CIENFUEGOS, MICHELE D (RN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:D
Last Name:CIENFUEGOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 BOLIN DR
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-1644
Mailing Address - Country:US
Mailing Address - Phone:509-930-1651
Mailing Address - Fax:
Practice Address - Street 1:141 WARD RD
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-9100
Practice Address - Country:US
Practice Address - Phone:509-865-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60095218163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool