Basic Information
| Provider Information | |||||||||
| NPI: | 1144371329 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHOLZ | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | RN, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1530 N 115TH ST | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981338411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065237246 | ||||||||
| FaxNumber: | 2065231252 | ||||||||
| Practice Location | |||||||||
| Address1: | 1530 N 115TH ST | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981338411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065237246 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2007 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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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 | 101Y00000X | RC00037980 | WA | Y | Behavioral Health & Social Service Providers | Counselor | 163WP0000X | RN00128482 | WA | N | Nursing Service Providers | Registered Nurse | Pain Management |
No ID Information.