Individual
MARY J GOLIGHTLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
751 NE BLAKELY DR STE 3020, ISSAQUAH, WA 98029-6201
(425) 313-5345
(425) 313-4704
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60177536
WA
363L00000X
Nurse Practitioner
Primary
AP61005908
WA
363LF0000X
Family Nurse Practitioner
AP61005908
WA
Other
Enumeration date
12/04/2019
Last updated
12/02/2022
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