Individual
HETAL PRAKASH KOTHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 493-4083
(360) 486-6436
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60076666
WA
208M00000X
Hospitalist Physician
MD60076666
WA
Other
Enumeration date
04/07/2009
Last updated
06/16/2021
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