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General NPI Number Information
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NPI Number | 1740224880
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Entity Type | Individual
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Provider Name | MARIE E. MATTY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 07/27/2024
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Provider Practice Location Address
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Address Line | 19980 10TH AVE NE STE 202
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City | POULSBO
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State | WA
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Zip | 98370-6322
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Country | US
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Telephone | 360-979-0569
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Fax | 877-805-9505
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Provider Business Mailing Address
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Address Line | PO BOX 2940
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City | POULSBO
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State | WA
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Zip | 98370-2940
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Country | US
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Telephone | 360-979-0569
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Fax | 877-805-9505
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD00041619
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00041619
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License Number State | WA
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