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Organization

MARY K. SIMONSON, MD PLLC

Active
Other names
Mary K. Simonson, MD
Organization subpart
No

Provider details

NPI number
Authorized official
MARY K SIMONSON MD (OWNER)
(253) 759-0288
Entity
Organization

Contact information

Practice address
4041 RUSTON WAY STE 202, TACOMA, WA 98402-5300
(253) 759-0288
(253) 761-3288
Mailing address
4041 RUSTON WAY STE 202, TACOMA, WA 98402-5300
(253) 759-0288
(253) 761-3288

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD0021289
WASHINGTON STATE DEPARTMENT OF HEALTH MEDICAL LICENSE
WA
Enumeration date
10/19/2020
Last updated
10/19/2020
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