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General NPI Number Information
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NPI Number | 1346043619
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Entity Type | Individual
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Provider Name | KARISSA BOTSET LPN
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 9115 154TH AVENUE CT NW
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City | LAKEBAY
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State | WA
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Zip | 98349-9850
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Country | US
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Telephone | 253-649-5080
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Fax | 360-252-7016
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Provider Business Mailing Address
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Address Line | 2128 69TH AVE W # E107
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-5856
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Country | US
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Telephone | 813-480-6498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP101070
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP61274753
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License Number State | WA
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