Healthcare Provider Details

I. General information

NPI: 1033122692
Provider Name (Legal Business Name): KATHLEEN PATTERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M/S A6901
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY, NE DEPARTMENT OF PATHOLOGY, A-6901
SEATTLE WA
98105
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2103
  • Fax: 206-987-3840
Mailing address:
  • Phone: 206-987-2103
  • Fax: 206-987-3840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberMD00029970
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: