Individual provider · Type 1 NPI
Marisa Dianna Mack-Booth
Nurse Practitioner · Tacoma, WA
Practice location
12180 Park Ave S
Tacoma, WA 98447-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | RN61087194 (WA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1447190129
Marisa Dianna Mack-Booth's National Provider Identifier is 1447190129, issued on Mar 31, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Tacoma, WA. The record was last updated on Sep 3, 2026.