Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP30006807 | WA |
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP30006807 | WA |
NPI | 1023053642 |
---|---|
Provider Name | Ms. Carlene D Oyetuga |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98109-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 20/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023053642 | (05) | WA |
Q70431 | (02) | WA |