Provider Demographics
NPI:1093826190
Name:KERCH, LOTCHIE MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:LOTCHIE
Middle Name:MARIE
Last Name:KERCH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:LOTCHIE
Other - Middle Name:MARIE
Other - Last Name:KERCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2919 27TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2827
Mailing Address - Country:US
Mailing Address - Phone:206-786-0064
Mailing Address - Fax:206-749-0009
Practice Address - Street 1:2919 27TH AVE W
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-2827
Practice Address - Country:US
Practice Address - Phone:206-786-0064
Practice Address - Fax:206-749-0009
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000303213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1093826190Medicaid
WA1115570001Medicare NSC
WATO1666Medicare UPIN
WAG8888375Medicare PIN