| Doctor Name: | MARY BETH VANBRONKHORST |
| NPI Number: | 1003823147 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA10002907 |
| Business Practice Address: | 407 E Main St Everson, WA - 982479525 |
| Business Phone Number: | 3609663441 |
| Business Fax Number: | 3609660969 |
| Mailing Address: | 709 W Orchard Dr, Suite #4 BELLINGHAM |
| State: | WA |
| Postal Code: | 982251766 |
| Phone Number: | 3603188800 |
| Fax Number: | 3603181085 |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA10002907 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |