Healthcare Provider Details

I. General information

NPI: 1649660465
Provider Name (Legal Business Name): CATHARIN MANEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHARIN MANEY DDS

II. Dates (important events)

Enumeration Date: 02/01/2015
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10521 MERIDIAN AVE N
SEATTLE WA
98133
US

IV. Provider business mailing address

PO BOX 3835
SEATTLE WA
98124-3835
US

V. Phone/Fax

Practice location:
  • Phone: 206-296-4990
  • Fax: 206-205-5142
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-762-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE60486666
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60486666
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: