Individual
MARIANA MCILWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
128 LILLY RD NE STE 202, OLYMPIA, WA 98506-7400
(360) 357-6314
Mailing address
128 LILLY RD NE STE 202, OLYMPIA, WA 98506-7400
(360) 357-6314
(360) 705-3745
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD60863106
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91-1829653
TAX ID
WA
Enumeration date
05/03/2018
Last updated
06/25/2018
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