Colleen Bothell, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60732007 Issued in WA

Practice address

12 S 8TH St
Yakima, WA 98901-3020

Phone

(509) 454-4143

NPI assigned

Mar 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1740640705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHELL",
        "first_name": "COLLEEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60732007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Borroff
• Alan Boschker, MPT
• Nichole Adrianne Bosma, FNP-C
• Alexis Bossert
• Kolton Richard Bostrom
• Tawnya Bothwell, ARNP
• John K Boucher, MD
• Sydney Bouchey, RPH
• Mark Ashraf Boules, M.D.
• Andrew Paseud Boupha, RPH

• Dentist in Yakima, WA
• Providers in Yakima, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.