Provider Demographics
NPI:1235109471
Name:LANDOWSKI, MARY ANNE ELIZABETH (RN00130116)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:ELIZABETH
Last Name:LANDOWSKI
Suffix:
Gender:F
Credentials:RN00130116
Other - Prefix:
Other - First Name:MARY ANNE
Other - Middle Name:ELIZABETH
Other - Last Name:LANDOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MSN, CWCN
Mailing Address - Street 1:29217 25TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:WA
Mailing Address - Zip Code:98580-7703
Mailing Address - Country:US
Mailing Address - Phone:253-968-2357
Mailing Address - Fax:253-968-5997
Practice Address - Street 1:MADIGAN ARMY MEDIAL CENTER
Practice Address - Street 2:9040A FITZSIMMONS AVE; C/O VASCULAR CLINIC
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2357
Practice Address - Fax:253-968-5997
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00130116163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care