Healthcare Provider Details

I. General information

NPI: 1821135005
Provider Name (Legal Business Name): MARY LYNNE BEMENT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CTR 9908 WEST JOHNSON STREET
TACOMA WA
98431-0001
US

IV. Provider business mailing address

5037 CHAMBERS CREEK LOOP SE
OLYMPIA WA
98501-7130
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-4238
  • Fax: 253-968-4229
Mailing address:
  • Phone: 253-968-4238
  • Fax: 253-968-4229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number401803-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: