MEDICARE: KATHERINE STULL

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1265223127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE STULL

Provider Business Mailing Address
First Line	:	1310 CEDAR AVE APT 204
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-3578
Country	:	US
Telephone Number	:	512-645-5217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 166TH PL NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-8402
Country	:	US
Telephone Number	:	425-949-0801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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Directions to “ KATHERINE STULL ” Practice Location

Language	Start Address	Practice Location

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