| NPI | 1225674963 |
|---|---|
| Doing Business As | HARBOR PEDIATRICS BY MARY BRIDGE CHILDREN'S |
| Entity Type | Organization |
| Authorized Contact | KELLY WILLIAMS Manager, Provider Data & Enrollment 253-459-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2019-11-18 |