Provider Demographics
NPI:1124178744
Name:POPE, MARY KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KATHERINE
Last Name:POPE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 NW MARKET ST
Mailing Address - Street 2:SUITE 509
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4030
Mailing Address - Country:US
Mailing Address - Phone:206-632-2292
Mailing Address - Fax:
Practice Address - Street 1:2208 NW MARKET ST
Practice Address - Street 2:SUITE 509
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4030
Practice Address - Country:US
Practice Address - Phone:206-632-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1813103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical