Provider Demographics
NPI:1689644429
Name:WOTRING, MARY R (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:R
Last Name:WOTRING
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1250 SW HELLER ST
Mailing Address - Street 2:#C3
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4587
Mailing Address - Country:US
Mailing Address - Phone:360-929-4651
Mailing Address - Fax:360-675-1453
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-4927
Practice Address - Country:US
Practice Address - Phone:360-257-9484
Practice Address - Fax:360-257-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000040341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical