Provider Demographics
NPI:1407008469
Name:NUNEZ, MARJORIE J (NP)
Entity Type:Individual
Prefix:MISS
First Name:MARJORIE
Middle Name:J
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1787
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-0292
Mailing Address - Country:US
Mailing Address - Phone:360-537-6470
Mailing Address - Fax:
Practice Address - Street 1:1006 N H ST FL 4
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520
Practice Address - Country:US
Practice Address - Phone:360-537-6470
Practice Address - Fax:360-537-6475
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13417363L00000X
WAAP60839112363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner