Doctor Name: | MRS. SUSAN L HOLTZCLAW |
NPI Number: | 1003118837 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP60185001 |
Business Practice Address: | 4800 Sand Point Way Ne Mailstop T-2108 Seattle, WA - 981053901 |
Business Phone Number: | 2069875691 |
Business Fax Number: | |
Mailing Address: | 4800 Sand Point Way Ne, Mailstop T-2108 SEATTLE |
State: | WA |
Postal Code: | 981053901 |
Phone Number: | 2069875691 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2010 |
NPI Last Update Date: | 10/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP60185001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |