Healthcare Provider Details

I. General information

NPI: 1578937934
Provider Name (Legal Business Name): NATALIYA BADOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18718 19TH DR SE
BOTHELL WA
98012-8718
US

IV. Provider business mailing address

18718 19TH DR SE
BOTHELL WA
98012-8718
US

V. Phone/Fax

Practice location:
  • Phone: 312-718-8777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172868
License Number StateVA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: