Individual provider Active NPI

Kathleen Potthoff, LICENSED MIDWIFE

  • Lactation Consultant (Non-RN)
  • Bellingham, WA
National Provider Identifier
1417368960
Registry record updated Apr 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
Practice address
2823 Orleans St
Bellingham, WA 98226-3545
Phone
(310) 503-0461
NPI assigned
May 17, 2014
Last updated
Apr 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 452 CA
Lactation Consultant (Non-RN) 174N00000X WA Primary

Addresses

Primary practice location

2823 Orleans St
Bellingham, WA 98226-3545

Mailing address

7830 NE 112TH St
Kirkland, WA 98034-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
452CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Resource Network 365 PLLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1417368960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 NE 112TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 ORLEANS ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982263545",
            "telephone_number": "310-503-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTHOFF",
        "first_name": "KATHLEEN",
        "credential": "LICENSED MIDWIFE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-17",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "452",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.