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NPI Code Detail

MEDICARE: MS. CAROL ANNE OTTEN L.M.P.

MEDICARE:  MS. CAROL ANNE OTTEN  L.M.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA60327797WA

General Provider Information

NPI Number : 1578800132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL ANNE OTTEN L.M.P.
Provider Business Mailing Address
First Line : 17500 25TH AVE NE UNIT D304
Second Line :
City : MARYSVILLE
State : WA
Zip : 98271-4791
Country : US
Telephone Number : 425-308-1673
Fax Number : 833-538-0165
Provider Business Practice Location Address
First Line : 3210 SMOKEY POINT DR STE 100
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-7805
Country : US
Telephone Number : 425-308-1673
Fax Number : 833-538-0165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2013
Last Update Date : 01/17/2023

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Directions to “ MS. CAROL ANNE OTTEN L.M.P.” Practice Location

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