Basic Information
Provider Information
NPI: 1821198920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOLEY
FirstName: ANNEMARIE
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1370 116TH AVE NE
Address2: SUITE 209
City: BELLEVUE
State: WA
PostalCode: 980043825
CountryCode: US
TelephoneNumber: 4254538406
FaxNumber: 4254534173
Practice Location
Address1: 1370 116TH AVE NE
Address2: SUITE 209
City: BELLEVUE
State: WA
PostalCode: 980043825
CountryCode: US
TelephoneNumber: 4254538406
FaxNumber: 4254534173
Other Information
ProviderEnumerationDate: 09/25/2006
LastUpdateDate: 06/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD00042600WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RN0300XMD00042600WAY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


Home