Individual
TERRY K MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
345 6TH ST STE 300, BREMERTON, WA 98337-1866
(360) 337-5235
(360) 337-5259
Mailing address
345 6TH ST STE 300, BREMERTON, WA 98337-1866
(360) 337-5235
(360) 337-5259
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP30000361
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137845
L & I
WA
05
—
9616400
—
WA
01
—
MA8337
REGENCE
—
Enumeration date
10/12/2006
Last updated
02/10/2012
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