Individual
MARY LOUISE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
400 E 5TH AVE, SPOKANE, WA 99202-1334
(509) 838-2531
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
(509) 838-2531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30007042
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9648585
—
WA
Enumeration date
01/18/2006
Last updated
11/25/2009
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