Samuel Winston Alvarico Indino Jr., LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00057744 Issued in WA

Practice address

9040 Reid Street, Attn:MCHJ-CLQ-C
Madigan Army Medical Center
Tacoma, WA 98431-1100

Phone

(253) 968-1110

Fax

(877) 874-1031

NPI assigned

Jan 7, 2016

Last updated

Jan 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1780040626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 REID STREET, ATTN:MCHJ-CLQ-C",
            "address_2": "MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 REID STREET, ATTN:MCHJ-CLQ-C",
            "address_2": "MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDINO",
        "first_name": "SAMUEL WINSTON",
        "middle_name": "ALVARICO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00057744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayne Immen
• In Bloom Acupuncture
• In the Heart of the Woods Psychology PLLC (Erin Tansill PLLC)
• Inclusive Mental Health Care
• Inclusive Mental Health Care
• Mirka Infante Robles
• Rose Infante
• Infinity Wellminds Services PLLC
• Sidra Aele Ing
• Gretchen Elaine Ingersoll, M.A. LMHC

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.