Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | AP 60630734 | WA |
NPI | 1023401627 |
---|---|
Provider Name | Mary Dam Harvey |
First Address | University Place, WA 98466-6301 |
Second Address | University Place, WA 98466-6301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2015 |
Last Update Date | 17/02/2016 |