Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 102799 | AK |
N | 2084N0402X | Child Neurologist | 263787 | MA |
Y | 2084N0402X | Child Neurologist | MD60485157 | WA |
NPI | 1396060612 |
---|---|
Provider Name | Miss Catherine Ellyn Otten |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 16/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1396060612 | (05) | WA |