MEDICARE: KATHERINE JOAN EASTIN DO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1578405353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JOAN EASTIN DO

Provider Business Mailing Address
First Line	:	819 S 13TH ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4112
Country	:	US
Telephone Number	:	360-814-6230
Fax Number	:	360-814-6240

Provider Business Practice Location Address
First Line	:	819 S 13TH ST
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4112
Country	:	US
Telephone Number	:	360-814-6230
Fax Number	:	360-814-6240

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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