Healthcare Provider Details

I. General information

NPI: 1346371002
Provider Name (Legal Business Name): KATHLEEN STINE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E MADISON ST
SEATTLE WA
98122-2959
US

IV. Provider business mailing address

2001 E MADISON ST
SEATTLE WA
98122-2959
US

V. Phone/Fax

Practice location:
  • Phone: 206-328-7722
  • Fax: 206-720-4657
Mailing address:
  • Phone: 206-328-7722
  • Fax: 206-720-4657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30003038
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberRN00111730
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: