Healthcare Provider Details

I. General information

NPI: 1467943860
Provider Name (Legal Business Name): KATHERINE MAIRE KLIMARA AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE MAIRE RUSSELL AU.D.

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE STE 150
SEATTLE WA
98104-2144
US

IV. Provider business mailing address

21911 76TH AVE W STE 211
EDMONDS WA
98026-7918
US

V. Phone/Fax

Practice location:
  • Phone: 425-775-6651
  • Fax: 425-670-6718
Mailing address:
  • Phone: 425-775-6651
  • Fax: 425-670-6718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000799
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number096122
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD70050886
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAUD70050886
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: