Provider Demographics
NPI:1699480350
Name:GONZALEZ ORTIZ, CYNTHIA (RN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:GONZALEZ ORTIZ
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 1:26009 27TH PL S APT P201
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-8903
Mailing Address - Country:US
Mailing Address - Phone:253-732-1750
Mailing Address - Fax:
Practice Address - Street 1:3701 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7838
Practice Address - Country:US
Practice Address - Phone:253-732-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61327854163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health