Individual
MARY R LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4005 HOYT AVE, EVERETT, WA 98201-4920
(425) 339-5468
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005324
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10005324
LICENSE
WA
Enumeration date
11/24/2008
Last updated
11/24/2008
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