Individual
MS. MARY L CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PRAC NURSE
Contact information
Practice address
2009 NE 117TH ST STE 101, VANCOUVER, WA 98686-4022
(360) 566-9112
(360) 566-9133
Mailing address
PO BOX 5677, VANCOUVER, WA 98668-5677
(360) 254-9311
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN00012716
WA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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