Provider Demographics
NPI:1679813877
Name:BARLOW, MARY DANELLE (RN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:DANELLE
Last Name:BARLOW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 696
Mailing Address - Street 2:64 MAIN STREET
Mailing Address - City:CATHLAMET
Mailing Address - State:WA
Mailing Address - Zip Code:98612
Mailing Address - Country:US
Mailing Address - Phone:360-795-6207
Mailing Address - Fax:360-795-6143
Practice Address - Street 1:64 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CATHLAMET
Practice Address - State:WA
Practice Address - Zip Code:98612
Practice Address - Country:US
Practice Address - Phone:360-795-6207
Practice Address - Fax:360-795-6143
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 60242779163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse