Provider Demographics
NPI:1730322033
Name:HOUSE, MOLLY D (DO)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:D
Last Name:HOUSE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 TONYA CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513
Mailing Address - Country:US
Mailing Address - Phone:360-742-7723
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431
Practice Address - Country:US
Practice Address - Phone:253-968-1930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE808207ZP0102X
VA0102206271207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
207ZP0102XOtherMILITARY HEALTH SYSTEM