Provider Demographics
NPI:1235029315
Name:BOLIN, TWAN ROCHELLE (NC10015364)
Entity type:Individual
Prefix:
First Name:TWAN
Middle Name:ROCHELLE
Last Name:BOLIN
Suffix:
Gender:F
Credentials:NC10015364
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17649 134TH LN SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6817
Mailing Address - Country:US
Mailing Address - Phone:206-487-9573
Mailing Address - Fax:
Practice Address - Street 1:17649 134TH LN SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-6817
Practice Address - Country:US
Practice Address - Phone:206-487-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC100153841376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide