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NPI Profile for MARY JANE LONG in TACOMA, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Administrator |
163WA2000X |
| NPI Number | 1508219734 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/23/2016 | |
| Last updated | 07/23/2016 - About 10 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MARY JANE LONG
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MARY JANE LONG