Provider Demographics
NPI:1861920530
Name:BENDERLIY, ROSALIA V (RN)
Entity type:Individual
Prefix:
First Name:ROSALIA
Middle Name:V
Last Name:BENDERLIY
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 1:18654 4TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3924
Mailing Address - Country:US
Mailing Address - Phone:206-356-6817
Mailing Address - Fax:
Practice Address - Street 1:10811 12TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-2125
Practice Address - Country:US
Practice Address - Phone:206-631-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60062417163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool