Healthcare Provider Details

I. General information

NPI: 1780860247
Provider Name (Legal Business Name): KATHI A JAMES OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21600 HIGHWAY 99 STE 150
EDMONDS WA
98026-8012
US

IV. Provider business mailing address

21600 HIGHWAY 99 STE 150
EDMONDS WA
98026-8012
US

V. Phone/Fax

Practice location:
  • Phone: 425-774-2636
  • Fax: 425-774-2688
Mailing address:
  • Phone: 425-774-2636
  • Fax: 425-774-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberOT000033278
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: