Healthcare Provider Details

I. General information

NPI: 1922292051
Provider Name (Legal Business Name): KARLYN B HUDDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARLYN G BOTT M.D.

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12333 NE 130TH LN STE 320
KIRKLAND WA
98034-7467
US

IV. Provider business mailing address

12333 NE 130TH LN STE 320
KIRKLAND WA
98034-7467
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-0555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD60449834
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: