1194461434 NPI number — MRS. MARGIE ANN WILLIAMS PMHNP

Table of content: MRS. MARGIE ANN WILLIAMS PMHNP (NPI 1194461434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194461434 NPI number — MRS. MARGIE ANN WILLIAMS PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
MARGIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PMHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194461434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7836 RIVERVIEW CT SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUMWATER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98501-6804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-332-3848
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4405 7TH AVE SE STE 200-0501
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LACEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98503-1062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-300-3303
Provider Business Practice Location Address Fax Number:
253-300-2030
Provider Enumeration Date:
05/10/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  APRN11020995 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: RN-61370274 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP-61370289 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0808X , with the licence number: RN9378900 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)