Provider Demographics
NPI:1376645846
Name:EMORY-HALL, NANCY MARGRET (LMP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MARGRET
Last Name:EMORY-HALL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:MARGRET
Other - Last Name:EMORY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:2809 ROCKEFELLER AVE
Mailing Address - Street 2:STE. C.
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3541
Mailing Address - Country:US
Mailing Address - Phone:360-658-2582
Mailing Address - Fax:425-259-2235
Practice Address - Street 1:2809 ROCKEFELLER AVE
Practice Address - Street 2:STE. C.
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3541
Practice Address - Country:US
Practice Address - Phone:360-658-2582
Practice Address - Fax:425-259-2235
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007907247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00007907OtherL.M.P.
WAEM5007OtherREGENCE BLUE SHIELD