Provider Demographics
NPI:1659550838
Name:CLEMENT, MARY LOUISE (ND)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LOUISE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LOUISE
Other - Last Name:GRIFFING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:8308 WARREN DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-265-8388
Mailing Address - Fax:253-265-1803
Practice Address - Street 1:8308 WARREN DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-265-8388
Practice Address - Fax:253-265-1803
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00112537163W00000X
WANT00000644175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No175F00000XOther Service ProvidersNaturopath