Individual
JANICE M GATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 428-2501
(360) 428-2596
Mailing address
1400 E. KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP60674772
WA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
OP60674772
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2037598
—
WA
Enumeration date
05/03/2014
Last updated
10/27/2021
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