Jansma, Mary Lucille

Jansma, Mary Lucille is an individual health care provider with primary practice located at 600 N. Broadway , Longview WA 98632-0302. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Jansma, Mary Lucille can be contacted via phone (360) 414-2177.

Contact Information

Primary practice address
600 N. Broadway Longview WA 98632-0302
Phone: (360) 414-2177
Fax: (360) 414-2210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP30005737 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30005737 Washington

Profile Details

NPI number 1811060874
LBN Legal business name Jansma, Mary Lucille
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Nov 14th, 2007 - about 18 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 1811060874 NPPES
Washington MEDICAID 9652611
Washington Other 8944406
Washington Other 0220991

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