Basic Information
Provider Information
NPI: 1700104825
EntityType: 2
ReplacementNPI:  
OrganizationName: ANNEMARIE C DOOLEY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2015 116TH AVE NE
Address2: SUITE B
City: BELLEVUE
State: WA
PostalCode: 980043018
CountryCode: US
TelephoneNumber: 2065925000
FaxNumber: 2068249510
Practice Location
Address1: 2015 116TH AVE NE
Address2: SUITE B
City: BELLEVUE
State: WA
PostalCode: 980043018
CountryCode: US
TelephoneNumber: 4254538406
FaxNumber: 4254534173
Other Information
ProviderEnumerationDate: 05/13/2010
LastUpdateDate: 05/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DOOLEY
AuthorizedOfficialFirstName: ANNEMARIE
AuthorizedOfficialMiddleName: C
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 4254538406
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XMD00042600WAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


Home