Provider Demographics
NPI:1407218969
Name:OATHES, MARI HAMMERQUIST (DO)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:HAMMERQUIST
Last Name:OATHES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:J
Other - Last Name:HAMMERQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2320 FREEWAY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-5445
Mailing Address - Country:US
Mailing Address - Phone:360-814-6870
Mailing Address - Fax:360-814-6922
Practice Address - Street 1:2320 FREEWAY DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5445
Practice Address - Country:US
Practice Address - Phone:360-814-6870
Practice Address - Fax:360-814-6922
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60949829208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics