Individual
MARLIN LEE JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1110
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C003250
AR
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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