Provider Demographics
NPI:1861470585
Name:KOTT-FLODSTROM, BETSY L (MD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:L
Last Name:KOTT-FLODSTROM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:KOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:901 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-7848
Mailing Address - Country:US
Mailing Address - Phone:360-452-2022
Mailing Address - Fax:360-457-1686
Practice Address - Street 1:901 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-7848
Practice Address - Country:US
Practice Address - Phone:360-452-2022
Practice Address - Fax:360-457-1686
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037625207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB35490Medicare ID - Type Unspecified