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Individual

BOBBIE MADDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
65 TAHUYEH DR NW, BREMERTON, WA 98312-9610
(360) 434-0045
Mailing address
65 TAHUYEH DR NW, BREMERTON, WA 98312-9610
(360) 434-0045

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60475888
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
163W00000X
163W00000X
WA
Enumeration date
12/13/2016
Last updated
12/13/2016
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