Provider Demographics
NPI:1053540393
Name:KENDZIORA, ALLISON LYNN (LPN)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:LYNN
Last Name:KENDZIORA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S. PROCTOR
Mailing Address - Street 2:COMPREHENSIVE MENTAL HEALTH/PEARL STREET CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465
Mailing Address - Country:US
Mailing Address - Phone:253-396-5930
Mailing Address - Fax:253-566-2252
Practice Address - Street 1:1201 S. PROCTOR
Practice Address - Street 2:COMPREHENSIVE MENTAL HEALTH/PEARL STREET CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465
Practice Address - Country:US
Practice Address - Phone:253-396-5930
Practice Address - Fax:253-566-2252
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00053321164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse