Individual
MOLLY JANE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1518 MAIN ST, SUMNER, WA 98390-1812
(253) 697-7400
Mailing address
1518 MAIN ST, SUMNER, WA 98390-1812
(253) 697-7400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
AP30007460
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30007460
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216687
STATE L&I
WA
01
—
0216688
STATE L&I
WA
01
—
8943398
STATE CRIME VICTIMS
WA
01
—
8943399
STATE CRIME VICTIMS
WA
05
—
9651548
—
WA
Enumeration date
01/09/2007
Last updated
05/26/2011
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