| NPI | 1073165593 |
|---|---|
| Former Name | MARY ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60969818) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA RN60361509) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2026-04-22 |