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1598728230 NPI number — CONNIE C PATULOT MD

NPI Number: 1598728230
Health Care Provider/Practitioner: CONNIE C PATULOT MD

Information about “1598728230” NPI (CONNIE C PATULOT MD) exists in 1598728230 in HTML format HTML  |  1598728230 in plain Text format TXT  |  1598728230 in PDF (Portable Document Format) PDF  |  1598728230 in an XML format XML  formats.

NPI Number : 1598728230 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598728230",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PATULOT",
    "FirstName": "CONNIE",
    "MiddleName": "C",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PATULOT",
    "OtherFirstName": "CONSOLACION",
    "OtherMiddleName": "C",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "4033 TALBOT RD S SUITE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RENTON",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98055",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "425-271-5437",
    "MailingAddressFaxNumber": "425-656-4212",
    "FirstLinePracticeLocationAddress": "4033 TALBOT RD S SUITE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RENTON",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98055",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "425-271-5437",
    "PracticeLocationAddressFaxNumber": "425-656-4212",
    "EnumerationDate": "04/11/2006",
    "LastUpdateDate": "02/18/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208000000X",
        "TaxonomyName": "Pediatrics Physician",
        "LicenseNumber": "MD00019440",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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