Individual
MARY C. WATHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, CNM
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30004769
WA
367A00000X
Advanced Practice Midwife
Primary
201150146NP
OR
367A00000X
Advanced Practice Midwife
AP30004769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263673
LABOR & INDUSTRIES
WA
05
—
500682873
—
OR
05
—
9630179
—
WA
Enumeration date
04/12/2006
Last updated
10/20/2020
Update your record
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