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General NPI Number Information
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NPI Number | 1699700245
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Entity Type | Individual
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Provider Name | ROWENA MADERAZO CARATAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 319 E PIONEER AVE
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City | MONTESANO
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State | WA
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Zip | 98563-4601
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Country | US
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Telephone | 360-533-4599
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Fax | 360-537-6514
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Provider Business Mailing Address
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Address Line | 615 N F ST
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City | ABERDEEN
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State | WA
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Zip | 98520-2657
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Country | US
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Telephone | 360-533-4599
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Fax | 360-537-6514
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00020781
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License Number State | WA
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