Individual provider · Type 1 NPI

Maryann Elizabeth Iversen, SUDPT

Student in an Organized Health Care Education/Training Program · Federal Way, WA

NPI number 1467193458 Active

Practice location

30620 Pacific Hwy S Ste 107
Federal Way, WA 98003-4888

Call (253) 941-7555 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XCO61285882 (WA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1467193458

Maryann Elizabeth Iversen, SUDPT's National Provider Identifier is 1467193458, issued on Apr 5, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Federal Way, WA. The record was last updated on Apr 5, 2022.