Healthcare Provider Details

I. General information

NPI: 1013832427
Provider Name (Legal Business Name): MS. HENRIETTE HOLLWEDEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18504 126TH AVE NE APT 1912
BOTHELL WA
98011-9344
US

IV. Provider business mailing address

18504 126TH AVE NE APT 1912
BOTHELL WA
98011-9344
US

V. Phone/Fax

Practice location:
  • Phone: 407-865-1868
  • Fax:
Mailing address:
  • Phone: 407-865-1868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN70010766
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: