is a Pediatrics in Mount Vernon, Washington. practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for is 1194982041. The last update date is .
's current location address is 2101 Little Mountain Ln, Mount Vernon, Washington. You can contact this provider via phone number 3604282622 and fax number 3604283941. The mailing address for is 2101 Little Mountain Ln, Mount Vernon, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 2101 Little Mountain Ln, Mount Vernon, Washington |
| Phone Number | 3604282622 |
| Fax Number | 3604283941 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1194982041 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 2101 Little Mountain Ln |
|---|---|
| City | Mount Vernon |
| State | Washington (WA) |
| Post Code | 982748752 |
| Phone Number | 3604282622 |
| Fax Number | 3604283941 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 363Lp0200X |
| Licence No | AP60020709 |
|
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9657297 | WA | -- |
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