# MOBILE HEALTHCARE PROVIDERS NORTHWEST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306235049
- **Authorized official:** MARY BUCKLAND APRN, FNP-BC (OWNER)
- **Authorized official phone:** (360) 773-7463

## Contact information

- **Practice address:** 415 SE 177TH AVE, VANCOUVER, WA 98683-4201
- **Practice address phone:** (360) 980-2441
- **Practice address fax:** (877) 491-4990
- **Mailing address:** PO BOX 728, CAMAS, WA 98607-0728
- **Mailing address phone:** (360) 980-2441
- **Mailing address fax:** (360) 831-0047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/19/2015
- **Last updated:** 01/26/2022