Basic Information
Provider Information
NPI: 1649494527
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: MARGO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2061 EAST MADISON STREET
Address2:  
City: SEATTLE
State: WA
PostalCode: 98122
CountryCode: US
TelephoneNumber: 8007690045
FaxNumber:  
Practice Location
Address1: 2001 E MADISON ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981222959
CountryCode: US
TelephoneNumber: 8007690045
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2007
LastUpdateDate: 10/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X1698HIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


Home