Chmelik, Mary R

Chmelik, Mary R is an individual health care provider with primary practice located at 311 S L St , Tacoma WA 98405-3720. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Chmelik, Mary R can be contacted via phone (253) 403-1449.

Contact Information

Primary practice address
311 S L St Tacoma WA 98405-3720
Phone: (253) 403-1449
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP 30005436 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30005436 Washington
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP30005436 Washington

Profile Details

NPI number 1194743757
LBN Legal business name Chmelik, Mary R
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Mar 7th, 2023 - about 2 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 1194743757 NPPES
Washington Other AP 30005436 PROFESSIONAL LICENSE
Washington MEDICAID 9625179 PROFESSIONAL LICENSE

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