Individual
EDITH ANN DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
702 N GRANITE AVE, GRANITE FALLS, WA 98252-8774
(360) 691-7791
(360) 238-4416
Mailing address
702 N GRANITE AVE # 98252, GRANITE FALLS, WA 98252-8774
(360) 691-7791
(360) 238-4416
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
60840166
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60840166
REGISTERED NURSE LICENSE
WA
Enumeration date
10/17/2018
Last updated
10/17/2018
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