Provider Demographics
NPI:1023366382
Name:PAYNE, MARY E (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4515 ML KING JR WAY S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2182
Mailing Address - Country:US
Mailing Address - Phone:206-320-5325
Mailing Address - Fax:206-320-5326
Practice Address - Street 1:4515 ML KING JR WAY S
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2182
Practice Address - Country:US
Practice Address - Phone:206-320-5325
Practice Address - Fax:206-320-5326
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WARN00045130163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management