MEDICARE: DR. JOHN DOLAN M.D.

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	2084P0800X	Psychiatry Physician	24340	CT

General Provider Information

NPI Number	:	1790843597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DOLAN M.D.

Provider Business Mailing Address
First Line	:	7683 SE 27TH ST # 475
Second Line	:
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2804
Country	:	US
Telephone Number	:	860-753-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	7683 SE 27TH ST # 475
Second Line	:
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2804
Country	:	US
Telephone Number	:	860-753-0010
Fax Number	:

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	12/07/2025

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