Individual
MARY L. COUCOULES
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3217 41ST AVE SW, SEATTLE, WA 98116-3444
(206) 937-1460
(206) 938-1990
Mailing address
325 9TH AVE, BOX 359735, SEATTLE, WA 98104-2420
(206) 341-4612
(206) 341-4614
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0076081
WA
367500000X
Certified Registered Nurse Anesthetist
AP30005708
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0196408
L&I PIN
WA
01
—
4143CO
REGENCE BLUE SHIELD PIN
WA
01
—
75366U
REGENCE BLUE SHIELD PIN
WA
05
—
9635034
—
WA
Enumeration date
05/20/2006
Last updated
09/11/2025
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