Individual
LYDIA FOTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 WASHINGTON AVE S, KENT, WA 98032-5709
(253) 833-7444
(253) 661-8631
Mailing address
325 W GOWE ST, KENT, WA 98032-5892
(253) 833-7444
(253) 661-8631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1679662
CO
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2153780
—
WA
Enumeration date
08/29/2019
Last updated
07/29/2026
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