Individual
MARY R CHMELIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-1449
Mailing address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-1449
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30005436
WA
363LF0000X
Family Nurse Practitioner
AP30005436
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP 30005436
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9625179
—
WA
01
—
AP 30005436
PROFESSIONAL LICENSE
WA
Enumeration date
07/18/2006
Last updated
03/07/2023
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