Individual provider Active NPI

Rozette Casene Henryalvarez, LPN

  • Licensed Practical Nurse
  • Renton, WA
National Provider Identifier
1295236867
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00057880 Issued in WA
Practice address
2403 Jones Ave S
Renton, WA 98055-4304
Phone
(206) 290-7006
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00057880 WA Primary

Addresses

Primary practice location

2403 Jones Ave S
Renton, WA 98055-4304

Mailing address

2602 Westridge Ave W Apt Y201
Tacoma, WA 98466-1892
Phone (253) 882-4401

Other names 1

  • Ms. Rozette Casene Bynum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00057880WAMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1295236867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 WESTRIDGE AVE W APT Y201",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984661892",
            "telephone_number": "253-882-4401",
            "fax_number": "866-360-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 JONES AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554304",
            "telephone_number": "206-290-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRYALVAREZ",
        "first_name": "ROZETTE",
        "middle_name": "CASENE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00057880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROZETTE",
            "last_name": "BYNUM",
            "middle_name": "CASENE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.