Provider Demographics
NPI:1093045064
Name:MARY MARTIN ARNP NURSING SERVICES PLLC
Entity Type:Organization
Organization Name:MARY MARTIN ARNP NURSING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-291-6644
Mailing Address - Street 1:4634 LUHR RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-2391
Mailing Address - Country:US
Mailing Address - Phone:206-291-6644
Mailing Address - Fax:360-459-0596
Practice Address - Street 1:4634 LUHR RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-2391
Practice Address - Country:US
Practice Address - Phone:206-291-6644
Practice Address - Fax:360-459-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty