MEDICARE: MARY CATHARINE PEW 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	MD00028662	WA

General Provider Information

NPI Number	:	1922008721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CATHARINE PEW MD

Provider Business Mailing Address
First Line	:	10501 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-9509
Country	:	US
Telephone Number	:	206-296-8421
Fax Number	:	206-205-5142

Provider Business Practice Location Address
First Line	:	10501 MERIDIAN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-9509
Country	:	US
Telephone Number	:	206-296-8421
Fax Number	:	206-205-5142

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	05/16/2013

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