Provider Demographics
NPI:1437127743
Name:SESSOMS, ROSE MARIE (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:MARIE
Last Name:SESSOMS
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17011 BIRDSONG LN SE
Mailing Address - Street 2:PO BOX 2910
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-7937
Mailing Address - Country:US
Mailing Address - Phone:360-894-6986
Mailing Address - Fax:360-894-6986
Practice Address - Street 1:3800 3RD ST SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-1109
Practice Address - Country:US
Practice Address - Phone:253-503-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0293196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8288482Medicaid
WAAB26396Medicare ID - Type Unspecified
WAD77283Medicare UPIN