Basic Information
| Provider Information | |||||||||
| NPI: | 1114541786 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOBIANSKI | ||||||||
| FirstName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34509 9TH AVE S | ||||||||
| Address2: | STE 304 | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980038709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539391230 | ||||||||
| FaxNumber: | 2539526824 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 MINOR AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063869505 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2020 | ||||||||
| LastUpdateDate: | 02/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN60758958 | WA | N | Nursing Service Providers | Registered Nurse | 363LG0600X | AP61187111 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363L00000X | AP61187111 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.