Individual
DR. MARY-ANN PRISCILLA BOLTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2105 112TH AVE NE, SUITE 200, BELLEVUE, WA 98004-2945
(425) 452-2964
Mailing address
2105 112TH AVE NE, SUITE 200, BELLEVUE, WA 98004
(425) 452-2964
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24128
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8114167
—
WA
01
—
BO4573
BLUESHIELD PIN
WA
Enumeration date
09/21/2006
Last updated
01/10/2011
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