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NPI Code Detail

MEDICARE: HENRY CHARLES KAUTH

MEDICARE: HENRY CHARLES KAUTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorCG60897677WA

General Provider Information

NPI Number : 1487125324
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY CHARLES KAUTH
Provider Business Mailing Address
First Line : 2970 SW AVALON WAY
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2551
Country : US
Telephone Number : 206-883-2051
Fax Number :
Provider Business Practice Location Address
First Line : 2970 SW AVALON WAY
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2551
Country : US
Telephone Number : 206-883-2051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2018
Last Update Date : 12/17/2018

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Directions to “ HENRY CHARLES KAUTH ” Practice Location

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