Individual
CAROLINE O AGBETUNSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7410 DELAWARE LN, SEA-MAR COMMUNITY HEALTH CENTER, VANCOUVAR, WA 91664-1408
(360) 896-5128
(360) 896-5179
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-3335
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11279
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504867
—
NV
05
—
100504870
—
NV
Enumeration date
01/23/2006
Last updated
02/13/2009
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