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General NPI Number Information
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NPI Number | 1023401627
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Entity Type | Individual
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Provider Name | MARY DAM HARVEY
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Gender | Female
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 4627 ALAMEDA AVE
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-6301
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Country | US
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Telephone | 253-988-1253
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Fax |
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Provider Business Mailing Address
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Address Line | 4627 ALAMEDA AVE
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-6301
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Country | US
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Telephone | 253-988-1253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN00150813
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP 60630734
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License Number State | WA
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