Individual provider · NPI-1

Alphonce Morango Boniphace

Registered Nurse, Registered Nurse First Assistant · Tacoma, WA

NPI number1306615992

StatusActive

Last updated in NPPESDec 26, 2023

Details

NPI: 1306615992
Entity type: Individual (NPI-1)
Name: Alphonce Morango Boniphace
Sex: Male
Sole proprietor: Yes
Enumeration date: Dec 26, 2023
Certification date: Dec 25, 2023
Last updated: Dec 26, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WR0006X	Registered Nurse, Registered Nurse First Assistant	NC61503287	WA	Yes

Practice location

5031 S Orchard St Apt B
Tacoma, WA 98467-3667

Phone 240-615-3791

Mailing address

5031 S Orchard St Apt B
Tacoma, WA 98467-3667

Phone 240-615-3791

Other practice locations

17 E 8th Ave
Spokane, WA 99202-1201

Phone 509-474-5678

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