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NPI Code Detail

MEDICARE: PAULINE S MEAD MSN, APRN, PMHNP

MEDICARE: PAULINE S MEAD MSN, APRN, PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP61646945WA

General Provider Information

NPI Number : 1366578338
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULINE S MEAD MSN, APRN, PMHNP
Provider Business Mailing Address
First Line : 2204 PACIFIC AVE N
Second Line :
City : LONG BEACH
State : WA
Zip : 98631-3300
Country : US
Telephone Number : 360-642-3787
Fax Number :
Provider Business Practice Location Address
First Line : 2204 PACIFIC AVE N
Second Line :
City : LONG BEACH
State : WA
Zip : 98631-3300
Country : US
Telephone Number : 360-642-3787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 10/21/2025

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