MARY K. SIMONSON, MD PLLC (NPI# 1295334555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295334555 |
| Entity Type | Organization |
| Organization Name | MARY K. SIMONSON, MD PLLC |
| Practice Address |
4041 Ruston Way Ste 202 Tacoma WA 98402-5300 |
| Practice Telephone | 2537590288 |
| Practice Fax Number | 2537613288 |
| Mailing Telephone | 2537590288 |
| Mailing Fax Number | 2537613288 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | MARY K SIMONSON (OWNER) |
| Authorized Official Telephone | 2537590288 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASHINGTON STATE DEPARTMENT OF HEALTH MEDICAL LICENSE | MD0021289 | 01 |
| Other Name | Type Code |
|---|---|
| Mary K. Simonson, MD | Former Legal Business Name - Organization |
| Street Address |
4041 RUSTON WAY STE 202 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902871320 | Mary Kathryn Hamilton | Psychologist | 4041 Ruston Way Ste 202, Tacoma, WA 98402-5300 | 2006-02-20 |
| 1730576778 | Rie Marie Adriana Sharky | Psychiatry & Neurology | 4041 Ruston Way Ste 202, Tacoma, WA 98402-5300 | 2015-04-16 |
| 1649221490 | Kirstin B Kirschner | Psychiatry & Neurology | 4041 Ruston Way Ste 202, Tacoma, WA 98402-5300 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154837854 | Pacific Northwest Lactation, LLC | Clinic/Center | 708 S Cushman Ave, Tacoma, WA 98405-3625 | 2017-12-18 |
| 1538308143 | Chris Nichols Md Ps | Clinic/Center | 6002 Westgate Blvd Ste 160, Tacoma, WA 98406-2571 | 2009-02-05 |
| 1033277694 | Mt Rainier Surgical Associates | Clinic/Center | 419 S L St Ste 101, Tacoma, WA 98405-3799 | 2006-12-05 |
| 1194083956 | Paul Andrew Sueno Md Pllc | Clinic/Center | 2411 S 19th St, Tacoma, WA 98405-2954 | 2012-04-30 |
| 1982871950 | Artistic Plastic Surgery Center Pllc | Clinic/Center | 3515 S 15th St, Suite #101, Tacoma, WA 98405-1952 | 2008-05-09 |
| 1144408840 | Ronald J Graf Md Ps | Clinic/Center | 1901 S Cedar St, #205, Tacoma, WA 98405-2308 | 2008-02-05 |
| 1811015399 | Surgical Weight Loss Clinic Pllc | Clinic/Center | 3716 Pacific Ave, Suite B, Tacoma, WA 98418-7836 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592946 | Inner Vitality Pllc | Clinic/Center | 11711 Ne 12th St Ste 1a, Bellevue, WA 98005-2461 | 2020-06-12 |
| 1578057337 | Regenerative Medicine Northwest | Clinic/Center | 1260 116th Ave Ne Ste 200, Bellevue, WA 98004-3800 | 2018-06-15 |
| 1275052458 | Peninsula Spine Institute, Ps | Clinic/Center | 804 Callahan Dr Ste A, Bremerton, WA 98310-3307 | 2017-09-19 |
| 1477097251 | Cynthia D Gray Md PC | Clinic/Center | 2101 Ne 139th St Ste 285, Vancouver, WA 98686-2326 | 2016-12-13 |
| 1811377484 | Knead To Heal, LLC | Clinic/Center | 2312 Rucker Ave, Everett, WA 98201-2723 | 2015-06-09 |
| 1699185348 | Duane Fredrick Hopp | Clinic/Center | 22612 126th Ave E, Graham, WA 98338-6725 | 2014-05-03 |
| 1689919292 | Poma Fertility, LLC | Clinic/Center | 12039 Ne 128th St Ste 110, Kirkland, WA 98034-3030 | 2012-12-07 |
| 1275888232 | Massage Mundo | Clinic/Center | 423 Eastlake Ave E, Seattle, WA 98109-5408 | 2012-07-16 |
| 1144536079 | 3-d Diagnostics, LLC | Clinic/Center | 2616 Yelm Hwy Se Ste A, Olympia, WA 98501-0800 | 2010-08-30 |
| 1588982060 | Assured Imaging Womens Wellness of Washington, LLC | Clinic/Center | 565 Andover Park W Ste 110, Tukwila, WA 98188-3357 | 2010-05-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.