| Doctor Name: | MARY ALOYSIA DOLAN |
| NPI Number: | 1245531045 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP60186964 |
| Business Practice Address: | 4401 Bridgeport Way W University Place, WA - 984664201 |
| Business Phone Number: | 2535644157 |
| Business Fax Number: | 2535644813 |
| Mailing Address: | 4401 Bridgeport Way W, UNIVERSITY PLACE |
| State: | WA |
| Postal Code: | 984664201 |
| Phone Number: | 2535644157 |
| Fax Number: | 2535644813 |
| NPI Enumeration Date: | 11/10/2010 |
| NPI Last Update Date: | 04/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP60186964 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |