Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP30005320 | WA |
NPI | 1003187352 |
---|---|
Provider Name | Ms. Mary Elizabeth Cain |
First Address | Shoreline, WA 98155-7104 |
Second Address | Shoreline, WA 98155-7104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2012 |
Last Update Date | 18/01/2012 |