Healthcare Provider Details

I. General information

NPI: 1710899331
Provider Name (Legal Business Name): BECKY E KATHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21701 76TH AVE W STE 304
EDMONDS WA
98026-7536
US

IV. Provider business mailing address

1728 W MARINE VIEW DR
EVERETT WA
98201-2094
US

V. Phone/Fax

Practice location:
  • Phone: 425-791-3084
  • Fax: 425-673-5466
Mailing address:
  • Phone: 425-259-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70178752-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: