Provider Demographics
NPI:1073918926
Name:GERLACH, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GERLACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 GUEMES VW
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-1118
Mailing Address - Country:US
Mailing Address - Phone:360-391-3901
Mailing Address - Fax:
Practice Address - Street 1:4607 GUEMES VW
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-1118
Practice Address - Country:US
Practice Address - Phone:360-391-3901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00047925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse