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General NPI Number Information
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NPI Number | 1568447472
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Entity Type | Individual
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Provider Name | DR. WENDY MA
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER DEPT OF OB/GYN
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-6023
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Fax | 253-968-1112
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Provider Business Mailing Address
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Address Line | 1913 HAMMOND AVE
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City | DUPONT
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State | WA
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Zip | 98327-9775
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Country | US
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Telephone | 253-968-1720
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Fax | 253-968-1112
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD050738L
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License Number State | PA
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