Healthcare Provider Details

I. General information

NPI: 1528007069
Provider Name (Legal Business Name): CLAUDIA M KALOTAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BOREN AVE #800
SEATTLE WA
98104
US

IV. Provider business mailing address

805 MADISON ST SUITE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 206-323-1900
  • Fax: 206-323-6868
Mailing address:
  • Phone: 206-264-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA10004964
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: