Healthcare Provider Details

I. General information

NPI: 1558919761
Provider Name (Legal Business Name): KATHLEEN ELIZABETH ROSENTHAL ARNP, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN ELIZABETH BARTH

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21616 76TH AVE W STE 205
EDMONDS WA
98026-7512
US

IV. Provider business mailing address

2428 NW MARKET ST APT 358
SEATTLE WA
98107-4168
US

V. Phone/Fax

Practice location:
  • Phone: 425-640-4810
  • Fax: 425-640-4884
Mailing address:
  • Phone: 406-253-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60954594
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP60994444
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP60994444
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: