Provider Demographics
NPI:1003187352
Name:CAIN, MARY ELIZABETH (ARNP, MC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:CAIN
Suffix:
Gender:F
Credentials:ARNP, MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 NE 155TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7104
Mailing Address - Country:US
Mailing Address - Phone:206-361-2379
Mailing Address - Fax:206-523-2978
Practice Address - Street 1:1424 NE 155TH ST STE 205
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7104
Practice Address - Country:US
Practice Address - Phone:206-361-2379
Practice Address - Fax:206-523-2978
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005320363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health