Healthcare Provider Details

I. General information

NPI: 1164844619
Provider Name (Legal Business Name): MONICA HAUSER RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2014
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 TOTEM BEACH RD
TULALIP WA
98271-6160
US

IV. Provider business mailing address

7520 TOTEM BEACH RD
TULALIP WA
98271-6160
US

V. Phone/Fax

Practice location:
  • Phone: 360-716-5725
  • Fax: 360-716-5780
Mailing address:
  • Phone: 360-716-5725
  • Fax: 360-716-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN60338138
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number172504
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: