Healthcare Provider Details

I. General information

NPI: 1841573169
Provider Name (Legal Business Name): KATE SORTUN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E
SEATTLE WA
98109
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-7222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60242650
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: