Individual
DR. CAROLA E BOSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 116TH AVE NE, SUITE 218, BELLEVUE, WA 98004-3045
(425) 454-3100
(425) 454-3101
Mailing address
1611 116TH AVE NE, SUITE 218, BELLEVUE, WA 98004-3045
(425) 454-3100
(425) 454-3101
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
26274
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00547255
AETNA
WA
01
—
1610BO
REGENCE BLUE SHIELD
WA
01
—
202124
VALUE OPTIONS
WA
Enumeration date
01/24/2007
Last updated
07/08/2007
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