NPI 1245494400

Mary van de Ven, LMP

Practitioner Specialist Des Moines, WA

Practice location

Address: 23619 14th Ave S, Des Moines, WA 98198-7402
Phone: (206) 878-1892

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MA 60016934 (WA)

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Registry record

NPI: 1245494400
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jul 2008
Record last updated: 16 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.