Provider Demographics
NPI:1154471589
Name:GOETSCH, CATHLEEN M (ARNP)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:M
Last Name:GOETSCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS:M4-PFS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005006363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8854035OtherKITSAP COUNTY
AKNP773WAMedicaid
WAUS7961028OtherAETNA SPECIALIST PIN
WA0039582OtherLABOR AND INDUSTRIES #
WA9627449Medicaid
WA2341GOOtherBLUE SHIELD #
WA500019672OtherRAILROAD MC
WAUS7961028OtherAETNA SPECIALIST PIN
AKNP773WAMedicaid