Provider Demographics
NPI:1922016500
Name:COHEN, BETTY ANN (MD)
Entity Type:Individual
Prefix:MISS
First Name:BETTY
Middle Name:ANN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 SUMMITVIEW AVE
Mailing Address - Street 2:#621
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3032
Mailing Address - Country:US
Mailing Address - Phone:509-573-3448
Mailing Address - Fax:509-574-4481
Practice Address - Street 1:206 S 11TH AVE
Practice Address - Street 2:SUITE 48
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3205
Practice Address - Country:US
Practice Address - Phone:509-575-5058
Practice Address - Fax:509-575-5196
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000435272083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E23447Medicare UPIN