Individual
MARY E FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
413 LILLY RD NE, PMG SW WA OLYMPIA PSYCHIATRY, OLYMPIA, WA 98506-5133
(360) 493-7060
(360) 493-7562
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60491874
WA
Other
Enumeration date
03/20/2013
Last updated
05/18/2021
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