Healthcare Provider Details
I. General information
NPI: 1821157025
Provider Name (Legal Business Name): CATHLYN SKERLONG KLASSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/06/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12800 BOTHELL EVERETT HWY
EVERETT WA
98208-6642
US
IV. Provider business mailing address
PO BOX 3360
PORTLAND OR
97208-3360
US
V. Phone/Fax
- Phone: 425-316-5180
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD00033057 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: