Provider Demographics
NPI:1558543579
Name:MURRAY, JOANNE LOUISE
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:LOUISE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 18TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2749
Mailing Address - Country:US
Mailing Address - Phone:360-352-4511
Mailing Address - Fax:360-754-4703
Practice Address - Street 1:2906 18TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2749
Practice Address - Country:US
Practice Address - Phone:360-352-4511
Practice Address - Fax:360-754-4703
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023144174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist