Individual
MARY LOUISE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1505 KLA-OOK-WA DR, TAHOLAH, WA 98587
(360) 276-4405
(360) 276-4474
Mailing address
1505 KLA-OOOK-WA DR, TAHOLAH, WA 98587
(360) 276-4405
(360) 276-4474
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30004102
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30004102
WA LICENSE
WA
Enumeration date
03/31/2008
Last updated
03/07/2023
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