Doctor Name: | MARION L VIGUS |
NPI Number: | 1538141346 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP30002543 |
Business Practice Address: | 800 West Maple Street Medical Lake, WA - 990220800 |
Business Phone Number: | 5092993121 |
Business Fax Number: | 5092997015 |
Mailing Address: | 800 West Maple Street, P O Box 800 MEDICAL LAKE |
State: | WA |
Postal Code: | 990220800 |
Phone Number: | 5092993121 |
Fax Number: | 5092997015 |
NPI Enumeration Date: | 11/17/2005 |
NPI Last Update Date: | 04/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | AP30002543 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |