Basic Information
| Provider Information | |||||||||
| NPI: | 1164990230 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERRY | ||||||||
| FirstName: | MISTI | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2520 101 ALABAMA STREET | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057656245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2901 SQUALICUM PKWY | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607886993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2018 | ||||||||
| LastUpdateDate: | 11/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN60646625 | WA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.