MEDICARE: CATHERINE COGLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD00045135	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD00045135	OTHER	WA	MD

General Provider Information

NPI Number	:	1366476509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE COGLEY MD

Provider Business Mailing Address
First Line	:	450 S KITSAP BLVD STE 230
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-3738
Country	:	US
Telephone Number	:	360-895-0216
Fax Number	:	360-895-7919

Provider Business Practice Location Address
First Line	:	450 S KITSAP BLVD STE 230
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-3738
Country	:	US
Telephone Number	:	360-895-0216
Fax Number	:	360-895-7919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/07/2023

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Directions to “ CATHERINE COGLEY MD” Practice Location

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