1942418173 NPI number — ANNE LOUISE KATHERINE M.A.

Table of content: ANNE LOUISE KATHERINE M.A. (NPI 1942418173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942418173 NPI number — ANNE LOUISE KATHERINE M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KATHERINE
Provider First Name:
ANNE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1942418173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 538
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COUPEVILLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98239-0538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-310-0361
Provider Business Mailing Address Fax Number:
361-678-8473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
627 5TH ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
MUKILTEO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98275-1580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-527-5492
Provider Business Practice Location Address Fax Number:
360-678-8473
Provider Enumeration Date:
05/20/2007

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: 101YM0800X , with the licence number:  LH00005446 , 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: 123306 123308 . This is a "PREMERA BLUE CROSS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8852KA . This is a "REGENCE BLUESHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com