Provider Demographics
NPI:1235474305
Name:FEATHERSTONE, MARIT ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIT
Middle Name:ANN
Last Name:FEATHERSTONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PACIFIC LUTHERAN UNIVERSITY HEALTH CTR
Mailing Address - Street 2:12180 PARK AVENUE SOUTH
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98447-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PACIFIC LUTHERAN UNIVERSITY HEALTH CTR
Practice Address - Street 2:12180 PARK AVENUE SOUTH
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98447-0001
Practice Address - Country:US
Practice Address - Phone:253-535-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60321918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily