Individual
DR. CARL OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 493-7230
(360) 493-4180
Mailing address
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 493-4002
(360) 493-5524
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21917
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982613709
—
WA
01
—
MD00021917
STATE LICENSE
WA
Enumeration date
08/08/2006
Last updated
01/18/2013
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