Individual
DR. MARY KATHLEEN DATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
6111 20TH ST E, FIFE, WA 98424-2098
(253) 926-2222
Mailing address
6111 20TH ST E, FIFE, WA 98424-2098
(253) 926-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NT00000541
WA
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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