Healthcare Provider Details
I. General information
NPI: 1679220321
Provider Name (Legal Business Name): MARTHA LEE HOLSCHEN FNTP, RWS3
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20314 45TH DR SE
BOTHELL WA
98012-7326
US
IV. Provider business mailing address
20314 45TH DR SE
BOTHELL WA
98012-7326
US
V. Phone/Fax
- Phone: 425-890-5268
- Fax:
- Phone: 425-890-5268
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: