| Doctor Name: | MARIENA MEARS |
| NPI Number: | 1417325093 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP60605295 |
| Business Practice Address: | 12215 245th Ave E Buckley, WA - 983219238 |
| Business Phone Number: | 3608970989 |
| Business Fax Number: | |
| Mailing Address: | Po Box 7087, BONNEY LAKE |
| State: | WA |
| Postal Code: | 983910708 |
| Phone Number: | 3608970989 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2015 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | AP60605295 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |