| Doctor Name: | MS. MARY LOUISE KROSKE |
| NPI Number: | 1013202852 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP30003741 |
| Business Practice Address: | 10500 Ne 86th St Vancouver, WA - 986622167 |
| Business Phone Number: | 4253596706 |
| Business Fax Number: | 3696046777 |
| Mailing Address: | 10500 Ne 86th St, VANCOUVER |
| State: | WA |
| Postal Code: | 986622167 |
| Phone Number: | 4253596706 |
| Fax Number: | 3696046777 |
| NPI Enumeration Date: | 06/09/2011 |
| NPI Last Update Date: | 06/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LS0200X |
| License Number: | AP30003741 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |