Active NPI
Mary Ellen Hargrave, M.D.
- Psychiatry Physician
- Kent, WA
National Provider Identifier
1578602777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD00043305
- Practice address
- 325 W Gowe St
Kent, WA 98032-5892 - Phone
- (253) 833-7444
- Fax
- (253) 735-1513
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD00043305 | WA | Primary |
Addresses
Primary practice location
325 W Gowe St
Kent, WA 98032-5892
Mailing address
3200 Shorewood Dr
#131
Mercer Island, WA 98040-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00043305 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Health and Hospitals | Past | Accepting new patients | |
| Louisiana Department of Health, Department of Health and Hospitals | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Dr. Joseph H. Tyler, Jr. Behavioral Health Clinic
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lafayette, LA
- NPI 1023162096
-
dba John J. Hainkel Jr. Home and and Rehabilitation Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1730674557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578602777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 SHOREWOOD DR",
"address_2": "#131",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980406200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W GOWE ST",
"city": "KENT",
"state": "WA",
"postal_code": "980325892",
"telephone_number": "253-833-7444",
"fax_number": "253-735-1513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGRAVE",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD00043305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.