Provider Demographics
NPI:1346589090
Name:KOTARSKI, CYNTHIA L (ND)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:L
Last Name:KOTARSKI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 50TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3215
Mailing Address - Country:US
Mailing Address - Phone:716-462-8844
Mailing Address - Fax:206-420-0813
Practice Address - Street 1:110 PREFONTAINE PL S STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3299
Practice Address - Country:US
Practice Address - Phone:206-420-0851
Practice Address - Fax:877-371-1974
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60342361175F00000X
VT099.0991116175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath