Provider Demographics
NPI:1366103640
Name:TELLO-CORDON, PLLC
Entity type:Organization
Organization Name:TELLO-CORDON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLO-CORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-937-1846
Mailing Address - Street 1:14353 27TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14353 27TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3431
Practice Address - Country:US
Practice Address - Phone:954-937-1846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty