Individual
MANDIE ROSE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
7146 COUNTRY VILLAGE DR SW, TUMWATER, WA 98512-7062
(219) 384-7104
Mailing address
7146 COUNTRY VILLAGE DR SW, TUMWATER, WA 98512-7062
(219) 384-7104
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61185174
WA
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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