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NPI Code Detail

MEDICARE: KATHERINE PEARCE NP

MEDICARE: KATHERINE PEARCE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP61369644WA

General Provider Information

NPI Number : 1174239917
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE PEARCE NP
Provider Business Mailing Address
First Line : 604 OAKESDALE AVE SW STE 102
Second Line :
City : RENTON
State : WA
Zip : 98057-5204
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 604 OAKESDALE AVE SW STE 102
Second Line :
City : RENTON
State : WA
Zip : 98057-5204
Country : US
Telephone Number : 253-697-3066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2023
Last Update Date : 04/26/2023

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