DR. CARRIE JEAN KAY GOTKOWITZ (NPI# 1679576540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679576540 |
| Entity Type | Individual |
| Full Name | DR. CARRIE JEAN KAY GOTKOWITZ |
| Credential | M.D. |
| Practice Address |
210 Se 136th Ave Vancouver WA 98684-6930 |
| Practice Telephone | 3609449889 |
| Practice Fax Number | 3609449686 |
| Mailing Telephone | 3609449889 |
| Mailing Fax Number | 3609449686 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2013-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD00030624 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 057518 | 05 | |
| WA | 1016103 | 05 |
| Street Address |
210 SE 136TH AVE |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-6930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508869546 | Matthew Charles Brouns | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-05-23 |
| 1194103176 | Marisa Osorio Gholson | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2015-05-11 |
| 1083991103 | Stephanie Brie Hudson | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2011-11-03 |
| 1851694202 | Tracy Lynn Webb | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2010-12-07 |
| 1114229374 | Joyce Marie Koerber | Physician Assistant | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2010-11-21 |
| 1942416524 | Nora Jane Bucher | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684 | 2007-05-14 |
| 1861567562 | David Peter Cosgrove | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-11-21 |
| 1750463485 | Dan Morris Hyder | Pathology | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-10-20 |
| 1104910850 | Toni Lucille Storm-dickerson | Surgery | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2006-10-03 |
| 1629062542 | Magdolna Solti | Internal Medicine | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-09-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
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| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609175660 | Legacy Salmon Creek Hospital | Radiology | 2121 Ne 139th St Ste 100, Vancouver, WA 98686-2316 | 2011-03-16 |
| 1164630752 | Michael Allan Myers | Radiology | 8821 Ne 5th St., Vancouver, WA 98664 | 2007-05-18 |
| 1902894793 | Won Sok Lee | Radiology | 2241 Ne 139th St, Vancouver, WA 98686-2742 | 2005-10-06 |
| 1487091260 | Shushan R Rana | Radiology | 8821 Ne 5th St, Vancouver, WA 98664 | 2013-06-03 |
| 1063648947 | Faisal Amin Siddiqui | Radiology | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2009-06-04 |
| 1194747733 | Stephen Christopher Hoffelt | Radiology | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2006-07-24 |
| 1336142926 | Scott Benjamin Schneider | Radiology | 210 Se 136th Ave, Vancouver, WA 98684-6930 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669829289 | Rosanna Hoi Lam Yeung | Radiology | 12040 Ne 128th St # Ms -63, Kirkland, WA 98034 | 2016-05-24 |
| 1508251000 | Anthony Hoai-nam Pham | Radiology | 19917 7th Ave Ne Ste 100, Poulsbo, WA 98370-6555 | 2015-04-01 |
| 1841603479 | Sherry Zhao | Radiology | 7350 W Deschutes Ave Ste A, Kennewick, WA 99336 | 2014-06-11 |
| 1467877670 | John Paul Lytle Jr. | Radiology | 6729 204th Dr. Ne, Redmond, WA 98053 | 2014-02-25 |
| 1962824219 | The Polyclinic | Radiology | 1225 Madison St, Seattle, WA 98104-1336 | 2014-01-06 |
| 1720356090 | Herbert Carl Berry | Radiology | 65 E. Roanoke St., Seattle, WA 98102 | 2011-12-01 |
| 1861794992 | Thomas Ward Griffin | Radiology | 3620 E Prospect St, Seattle, WA 98112-4440 | 2010-11-22 |
| 1407170467 | Aaron Shingo Kusano | Radiology | 1959 Ne Pacific St. Box 356043, University of Washington Department of Radiation Oncolo, Seattle, WA 98195 | 2010-03-19 |
| 1184866527 | Justin William Suszko | Radiology | 4525 3rd Ave Se Ste 100, Lacey, WA 98503-1010 | 2009-03-31 |
| 1194800904 | Lawrence Edmond Mulkerin | Radiology | University of Washington Medical Ct, 1959 Ne Pacific Street, Seattle, WA 98195-0001 | 2006-10-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.