Individual
MARA WYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 NORTH A STREET, BUCKLEY, WA 98321
(360) 829-6049
(360) 829-3388
Mailing address
329B PEARL ST, BUCKLEY, WA 98321-9641
(360) 829-6049
(360) 829-3388
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00054892
WA
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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