Healthcare Provider Details

I. General information

NPI: 1972588820
Provider Name (Legal Business Name): MARIA ANNE PIELAET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 159TH AVE NE
REDMOND WA
98052-6309
US

IV. Provider business mailing address

3925 159TH AVE NE
REDMOND WA
98052-6309
US

V. Phone/Fax

Practice location:
  • Phone: 425-216-0550
  • Fax: 425-216-0552
Mailing address:
  • Phone: 425-216-0550
  • Fax: 425-216-0552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG61561
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD 60295586
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: