Provider Demographics
NPI:1356060669
Name:WILLIAMS, DENISE L
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:L
Other - Last Name:MUMBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14913 SE MILL PLAIN BLVD APT E33
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8245
Mailing Address - Country:US
Mailing Address - Phone:757-675-8090
Mailing Address - Fax:
Practice Address - Street 1:14913 SE MILL PLAIN BLVD APT E31
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8245
Practice Address - Country:US
Practice Address - Phone:470-758-5798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider