Provider Demographics
NPI:1275975112
Name:PALOTAS, MARY ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:PALOTAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 SE GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-4009
Mailing Address - Country:US
Mailing Address - Phone:509-386-5205
Mailing Address - Fax:509-529-9858
Practice Address - Street 1:955 SE GARRISON DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-4009
Practice Address - Country:US
Practice Address - Phone:509-386-5205
Practice Address - Fax:509-529-9858
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00063710163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse