Groda-Lewis, Mary Louise

Groda-Lewis, Mary Louise is an individual health care provider with primary practice located at 1322 3Rd St Se Ste 240, Puyallup WA 98372-3771. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Groda-Lewis, Mary Louise can be contacted via phone (253) 697-5757.

Contact Information

Primary practice address
1322 3Rd St Se Ste 240 Puyallup WA 98372-3771
Phone: (253) 697-5757
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 38085 Iowa
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD00038716 Washington
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD00038716 Washington
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD00038716 Washington

Profile Details

NPI number 1598719825
LBN Legal business name Groda-Lewis, Mary Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Nov 1st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598719825 NPPES
Iowa Other P00677919 RR MEDICARE

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