1790866234 NPI number — MRS. KATHERINE EVE SIPIORSKI LMT

Table of content: MRS. KATHERINE EVE SIPIORSKI LMT (NPI 1790866234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790866234 NPI number — MRS. KATHERINE EVE SIPIORSKI LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIPIORSKI
Provider First Name:
KATHERINE
Provider Middle Name:
EVE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUERR
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
EVE SIPIORSKI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790866234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 78063
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98178-0063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-931-2907
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11521 NE 21ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004-3026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-931-2907
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA00021057 , 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)





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