Mary Jane Hall, ARNP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

AP30001925 Issued in WA

Practice address

971 11TH Ave
Longview, WA 98632-2503

Phone

(360) 577-1771

Fax

(360) 423-1405

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1245279587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322503",
            "telephone_number": "360-577-1771",
            "fax_number": "360-423-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322503",
            "telephone_number": "360-577-1771",
            "fax_number": "360-423-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "AP30001925",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "RN00097178",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9605767",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther I Haberman, LICENSED OPTICIAN
• Jennifer Fae Hale, RN
• Cassie N Hall
• Devin Shawn Hall
• Jeralee Hall, AAC
• Shenandoah J Hallstrom
• Nichol Suzanne Halverson, ARNP
• Beverly J. Hamlik, ARNP
• Crystal K Hammers, LMP, LMT
• Robert Lee Hammon, DDS

• Pediatrics Physician in Longview, WA
• Providers in Longview, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.