Provider Demographics
NPI:1972588820
Name:PIELAET, MARIA ANNE (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANNE
Last Name:PIELAET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 159TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6309
Mailing Address - Country:US
Mailing Address - Phone:425-216-0550
Mailing Address - Fax:425-216-0552
Practice Address - Street 1:3925 159TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6309
Practice Address - Country:US
Practice Address - Phone:425-216-0550
Practice Address - Fax:425-216-0552
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61561207Q00000X
WAMD 60295586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E75085Medicare UPIN
CA00G615610Medicare ID - Type Unspecified