Provider Demographics
NPI:1417692146
Name:GARCHITORENA, CATHERINE BEREDO
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BEREDO
Last Name:GARCHITORENA
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 1:18930 BOTHELL EVERETT HWY APT C103
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6849
Mailing Address - Country:US
Mailing Address - Phone:425-293-5338
Mailing Address - Fax:
Practice Address - Street 1:18930 BOTHELL EVERETT HWY APT C103
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6849
Practice Address - Country:US
Practice Address - Phone:425-293-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202004746RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse