Provider Demographics
NPI:1841613221
Name:ASKEW, MARY (LMP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ASKEW
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 EGG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-7045
Mailing Address - Country:US
Mailing Address - Phone:360-378-2914
Mailing Address - Fax:
Practice Address - Street 1:117 EGG LAKE RD
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-7045
Practice Address - Country:US
Practice Address - Phone:360-378-2914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015579171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor