Provider Demographics
NPI:1972673655
Name:BATIK, ODETTE (MD)
Entity type:Individual
Prefix:DR
First Name:ODETTE
Middle Name:
Last Name:BATIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2009
Mailing Address - Country:US
Mailing Address - Phone:206-784-9815
Mailing Address - Fax:
Practice Address - Street 1:14350 SE EASTGATE WAY
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-6458
Practice Address - Country:US
Practice Address - Phone:206-296-9754
Practice Address - Fax:206-296-0577
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0000024008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8113839Medicaid
WA0041773OtherL & I
WA0041773OtherL & I
WAF53581Medicare UPIN