Individual
MARY MICHAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
19401 NE 63RD ST, VANCOUVER, WA 98682-0003
(360) 521-6279
Mailing address
PO BOX 820175, VANCOUVER, WA 98682-0003
(360) 521-6279
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00119249
WA
Other
Enumeration date
05/23/2013
Last updated
09/05/2014
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