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General NPI Number Information
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NPI Number | 1720744493
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Entity Type | Organization
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Legal Business Name | GRACE BIBLE CHURCH OF MARYSVILLE
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 8521 67TH AVE NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-7855
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Country | US
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Telephone | 360-659-8517
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Fax | 360-653-5899
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Provider Business Mailing Address
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Address Line | 8521 67TH AVE NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-7855
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Country | US
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Telephone | 360-659-8517
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Fax | 360-653-5899
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Authorized Official
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Title or Position | ATHLETIC DIRECTOR
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Name | MARK RUHLMAN
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Credential |
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Telephone | 425-879-3372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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