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General NPI Number Information
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NPI Number | 1366571051
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Entity Type | Individual
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Provider Name | MINDY M HAYES LMP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5600 PACIFIC AVE SE
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City | LACEY
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State | WA
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Zip | 98503-1258
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Country | US
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Telephone | 360-493-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 18940 MELON ST SW
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City | ROCHESTER
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State | WA
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Zip | 98579-9117
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Country | US
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Telephone | 360-273-8319
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00013183
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License Number State | WA
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