1932565017 NPI number — KATIJEAN THORPE, MSW, P.S.

Table of content: KIM I. NEWTON M.D. (NPI 1932151362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932565017 NPI number — KATIJEAN THORPE, MSW, P.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATIJEAN THORPE, MSW, P.S.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932565017
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 274
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT ANGELES
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98362-0045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-565-6028
Provider Business Mailing Address Fax Number:
360-323-6403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9732 OLD OLYMPIC HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEQUIM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98382-3150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-565-6028
Provider Business Practice Location Address Fax Number:
360-323-6403
Provider Enumeration Date:
01/06/2016

Additional Information

Authorized Official

Authorized Official Last Name:
THORPE
Authorized Official First Name:
KATIJEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
360-565-6028

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LW 60063910 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G8914039 . This is a "PTAN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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