Individual
MS. MALLORY MARIE SOMERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
401 15TH AVE SE, PUYALLUP, WA 98372-3715
(253) 697-1617
Mailing address
6407 83RD AVENUE CT W, UNIVERSITY PLACE, WA 98467-3904
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60788778
WA
163WI0600X
Infection Control Registered Nurse
Primary
RN60788778
WA
163WM0705X
Medical-Surgical Registered Nurse
RN60788778
WA
163WX0800X
Orthopedic Registered Nurse
RN60788778
WA
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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