Individual
MARY PRATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 SHOESHEL DR, SEDRO WOOLLEY, WA 98284-4311
(360) 854-1891
Mailing address
720 SHOESHEL DR, SEDRO WOOLLEY, WA 98284-4311
(360) 854-1891
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276-756
—
WA
Enumeration date
08/25/2014
Last updated
08/25/2014
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