Mary Kathleen Data, N.D.

Individual provider Active NPI Family Medicine Physician · Fife, WA

NPI 1285655779 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1285655779
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
NT00000541 (WA)
Practice address
6111 20TH St E
Fife, WA 98424-2098
Phone
(253) 926-2222
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NT00000541WAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NT00000541 WA Yes

Addresses

Primary practice location

6111 20TH St E
Fife, WA 98424-2098

Mailing address

6111 20TH St E
Fife, WA 98424-2098
Phone (253) 926-2222

Other names

  • Dr. Katie Data Professional name

Other providers in Fife, WA

All providers in Fife, WA · Family Medicine Physician in Washington

Sources for this page

Verify at the official NPI Registry.