Individual
MARINA VIKTOROVNA DOLMATOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2622 S MERIDIAN, PUYALLUP, WA 98373-1500
(253) 841-2453
(253) 840-5519
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN60656201
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61194717
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AP61194717
—
WA
Enumeration date
08/02/2019
Last updated
06/02/2025
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