Healthcare Provider Details

I. General information

NPI: 1144371329
Provider Name (Legal Business Name): MARY J. SCHOLZ RN, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 N 115TH ST SUITE 207
SEATTLE WA
98133-8411
US

IV. Provider business mailing address

1530 N 115TH ST SUITE 207
SEATTLE WA
98133-8411
US

V. Phone/Fax

Practice location:
  • Phone: 206-523-7246
  • Fax:
Mailing address:
  • Phone: 206-523-7246
  • Fax: 206-523-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRC00037980
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberRN00128482
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: