Individual
MARIE E. MATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19980 10TH AVE NE STE 202, POULSBO, WA 98370-6322
(360) 979-0569
(877) 805-9505
Mailing address
PO BOX 2940, POULSBO, WA 98370-2940
(360) 979-0569
(877) 805-9505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00041619
WA
207VX0000X
Obstetrics Physician
MD00041619
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017760
—
WA
01
—
172437
LABOR & INDUSTRIES
WA
01
—
7810457
AETNA
—
01
—
8918MA
REGENCE BLUE SHIELD
—
01
—
P00045620
RAILROAD MEDICARE
—
Enumeration date
06/16/2006
Last updated
07/27/2024
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