Healthcare Provider Details

I. General information

NPI: 1265688121
Provider Name (Legal Business Name): MRS. VIORICA MURESAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICKI MURESAN

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18716 NE DAVIS RD
BRUSH PRAIRIE WA
98606
US

IV. Provider business mailing address

18716 NE DAVID RD
BRUSH PRAIRIE WA
98606
US

V. Phone/Fax

Practice location:
  • Phone: 360-892-7162
  • Fax:
Mailing address:
  • Phone: 360-892-7162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: