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DR. NICI EDDY BOTHWELL MD

Physicians Otolaryngology

Provider NPI: 1033195417

Provider Information:
DR. NICI EDDY BOTHWELL MD
Gender: F
Not Sole Proprietor

Practice Location:
104 27TH AVE SE  PUYALLUP, WA 98374-1145 US
Tel: 253-770-9000  Fax: 253-770-9712

Business Mailing Address:
PO BOX 1205  PUYALLUP, WA 98371-0231 US
Tel: 253-770-9000  Fax: 253-770-9712

NPI Information:
NPI: 1033195417
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Y00000XPhysicians
Otolaryngology
WAMD60209581
N207Y00000XPhysicians
Otolaryngology
HI12650
N207YS0012XPhysicians
Otolaryngology
HI12650
N207YS0012XPhysicians
Otolaryngology
WAMD60209581

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207Y00000X

Type:

Classification:



Definition:



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