Provider Demographics
NPI:1255486577
Name:RAWLINS, MARY WISTER (MS)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:WISTER
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W HOLLY ST
Mailing Address - Street 2:SUITE 331
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4364
Mailing Address - Country:US
Mailing Address - Phone:360-734-5100
Mailing Address - Fax:360-734-5100
Practice Address - Street 1:203 W HOLLY ST
Practice Address - Street 2:SUITE 331
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4364
Practice Address - Country:US
Practice Address - Phone:360-734-5100
Practice Address - Fax:360-734-5100
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health