Provider Demographics
NPI:1922008721
Name:PEW, MARY CATHARINE (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHARINE
Last Name:PEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 MERIDIAN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9509
Mailing Address - Country:US
Mailing Address - Phone:206-296-8421
Mailing Address - Fax:206-205-5142
Practice Address - Street 1:10501 MERIDIAN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9509
Practice Address - Country:US
Practice Address - Phone:206-296-8421
Practice Address - Fax:206-205-5142
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028662208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics