Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP30005721 | WA |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP30005721 | WA |
NPI | 1053357939 |
---|---|
Provider Name | Ms. Betty A Westfall |
First Address | Portland, OR 97208-3360 |
Second Address | Snohomish, WA 98290-1749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 13/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9633959 | (05) | WA |
G8936445 | (02) | WA |
P19244 | (02) | WA |