Provider Demographics
NPI:1144662008
Name:MESIAS, ROLANA O (FNP-BC, RN)
Entity type:Individual
Prefix:MRS
First Name:ROLANA
Middle Name:O
Last Name:MESIAS
Suffix:
Gender:F
Credentials:FNP-BC, RN
Other - Prefix:MS
Other - First Name:ROLANA
Other - Middle Name:C
Other - Last Name:ORAVILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:4112 HARBOUR POINTE BLVD SW
Practice Address - Street 2:SUITE 100
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-5457
Practice Address - Country:US
Practice Address - Phone:425-347-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-20
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY657479-1163W00000X
WAAP60485684363LF0000X
WARN60485683163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8935318Medicare UPIN