| Carol J Hathaway Mn Arnp Inc | |
|
113 S Eunice St Port Angeles WA 98362-3333 | |
| (360) 452-1775 | |
| (360) 452-1722 |
| Full Name | Carol J Hathaway Mn Arnp Inc |
|---|---|
| Speciality | Counselor |
| Location | 113 S Eunice St, Port Angeles, Washington |
| Authorized Official Name and Position | Carol J Hathaway (OWNER) |
| Authorized Official Contact | 3604521775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol J Hathaway Mn Arnp Inc Po Box 637 Port Angeles WA 98362-0113 Ph: (360) 452-1775 | Carol J Hathaway Mn Arnp Inc 113 S Eunice St Port Angeles WA 98362-3333 Ph: (360) 452-1775 |
| NPI Number | 1750597803 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 02/08/2012 |
| Medicare PECOS PAC ID | 4486631439 |
|---|---|
| Medicare Enrollment ID | O20040707000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750597803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | AP30006082 (Washington) | Primary |
| Provider Name | Carol J Hathaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518001668 PECOS PAC ID: 1658362348 Enrollment ID: I20040520001531 |
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