Provider Demographics
NPI:1346673662
Name:POMIETTO, MAUREEN LYNN (RN, MN)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:LYNN
Last Name:POMIETTO
Suffix:
Gender:F
Credentials:RN, MN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:LOPEZ ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98261-8000
Mailing Address - Country:US
Mailing Address - Phone:360-468-2201
Mailing Address - Fax:360-468-2235
Practice Address - Street 1:86 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:LOPEZ ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98261-8000
Practice Address - Country:US
Practice Address - Phone:360-468-2201
Practice Address - Fax:360-468-2235
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-11
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00076414163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool