Provider Demographics
NPI:1639631815
Name:WITCHELL, COSETTE FRANCESCA (CBT)
Entity Type:Individual
Prefix:
First Name:COSETTE
Middle Name:FRANCESCA
Last Name:WITCHELL
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6581 137TH PL NE APT 479
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-9740
Mailing Address - Country:US
Mailing Address - Phone:920-944-5008
Mailing Address - Fax:
Practice Address - Street 1:14012 163RD PL SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-3662
Practice Address - Country:US
Practice Address - Phone:209-214-7516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician