MEDICARE: MS. CATHERINE E CARTER FNP

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
1	363LF0000X	Family Nurse Practitioner	AP30006378	WA
2	363LF0000X	Family Nurse Practitioner		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A3503 H9	OTHER	OR	PACIFIC SOURCE HEALTH PLA

General Provider Information

NPI Number	:	1982673463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE E CARTER FNP

Provider Business Mailing Address
First Line	:	12360 LAKE CITY WAY NE STE 200
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5447
Country	:	US
Telephone Number	:	206-384-4382
Fax Number	:	206-440-3137

Provider Business Practice Location Address
First Line	:	12360 LAKE CITY WAY NE STE 200
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-5447
Country	:	US
Telephone Number	:	206-384-4382
Fax Number	:	206-440-3137

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	03/07/2023

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