Individual
CIERA CAPRICE BOTZHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
EASTERN STATE HOSPITAL, 850 MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-4705
Mailing address
EASTERN STATE HOSPITAL, PO BOX 800, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(509) 565-4705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PY60820221
WA
Other
Enumeration date
01/22/2014
Last updated
07/18/2018
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