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General NPI Number Information
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NPI Number | 1801080221
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Entity Type | Organization
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Legal Business Name | CYNTHIA L DESMOND MSN ARNP INC PS
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 1818 SO UNION AVE SUITE 2A
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-473-7637
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Fax | 253-671-8472
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Provider Business Mailing Address
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Address Line | 1818 SO UNION AVE SUITE 2A
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-473-7637
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Fax | 253-671-8472
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Authorized Official
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Title or Position | PRESIDENT ET AL
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Name | MRS. CYNTHIA L DESMOND
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Credential | ARNP
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Telephone | 253-473-7637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30004043
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License Number State | WA
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