Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | OR | |
N | 363LW0102X | Nurse Practitioner - Women's Health | 094006381N7 | OR |
NPI | 1043288491 |
---|---|
Provider Name | Theresa A Danscuk-Sloan |
First Address | Victor, MT 59875 |
Second Address | Bremerton, WA 98312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 08/07/2007 |