Hernandez, Marylou

Hernandez, Marylou is an individual health care provider with primary practice located at 8202 134Th St Se , Snohomish WA 98296-5938. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Hernandez, Marylou can be contacted via phone (206) 459-2847.

Contact Information

Primary practice address
8202 134Th St Se Snohomish WA 98296-5938
Phone: (206) 459-2847
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10004360 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 013704 New York

Profile Details

NPI number 1013987379
LBN Legal business name Hernandez, Marylou
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jul 13th, 2010 - about 14 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 1013987379 NPPES
Washington Other 0163636 DEPT. OF LABOR & INDUSTRI
Washington Other 0515HE DEPT. OF LABOR & INDUSTRI
Washington MEDICAID 8353773 DEPT. OF LABOR & INDUSTRI

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