Healthcare Provider Details

I. General information

NPI: 1023091998
Provider Name (Legal Business Name): CATHERINE ELIZABETH OVERSTREET CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 NE 127TH ST
SEATTLE WA
98125-4415
US

IV. Provider business mailing address

14332 32ND AVE NE APT B
SEATTLE WA
98125-3622
US

V. Phone/Fax

Practice location:
  • Phone: 206-362-7572
  • Fax:
Mailing address:
  • Phone: 206-365-3453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberVA00058466
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: