Healthcare Provider Details

I. General information

NPI: 1437127743
Provider Name (Legal Business Name): ROSE MARIE SESSOMS M.D.,M.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 3RD ST SE
PUYALLUP WA
98374-1109
US

IV. Provider business mailing address

17011 BIRDSONG LN SE PO BOX 2910
YELM WA
98597-7937
US

V. Phone/Fax

Practice location:
  • Phone: 253-503-0226
  • Fax:
Mailing address:
  • Phone: 360-894-6986
  • Fax: 360-894-6986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0293196
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: