Individual
MOLLY GRETCHEN BOETTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
602 MELROSE AVE E APT 201, SEATTLE, WA 98102-4744
(206) 499-4314
Mailing address
602 MELROSE AVE E APT 201, SEATTLE, WA 98102-4744
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60270983
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1268482
AMTA
WA
01
—
611984-11
NCBTMB
WA
01
—
MA60270983
WASHINGTON STATE LICENSE
WA
Enumeration date
04/04/2012
Last updated
04/04/2012
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