Provider Demographics
NPI:1770534463
Name:GOTCHY, CELESTINE A (ARNP)
Entity type:Individual
Prefix:
First Name:CELESTINE
Middle Name:A
Last Name:GOTCHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-7974
Practice Address - Fax:360-676-2567
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA028781OtherLABOR &INDUSTRIES (REG)
WA3976GOOtherREGENCE
WA9648643Medicaid
WA8941434OtherLABOR & INDUSTRIES (CV)
WAP00411383OtherRR MEDICARE
WAQ69723Medicare UPIN
WA3976GOOtherREGENCE