Healthcare Provider Details

I. General information

NPI: 1659799070
Provider Name (Legal Business Name): KATHARINE KINSMAN PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHARINE MCGRATH PHARM.D.

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E
SEATTLE WA
98109-4405
US

IV. Provider business mailing address

PO BOX 19023
SEATTLE WA
98109-1023
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-6279
  • Fax:
Mailing address:
  • Phone: 206-288-6279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPH00069490
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number0202207571
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: