Healthcare Provider Details

I. General information

NPI: 1013531755
Provider Name (Legal Business Name): MERCY CURTIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33480 13TH PL S
FEDERAL WAY WA
98003-6357
US

IV. Provider business mailing address

33480 13TH PL S
FEDERAL WAY WA
98003-6357
US

V. Phone/Fax

Practice location:
  • Phone: 253-285-7101
  • Fax:
Mailing address:
  • Phone: 253-285-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberLP60759548
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: