Healthcare Provider Details

I. General information

NPI: 1073806857
Provider Name (Legal Business Name): KATIE MCGUIRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST SUITE 1500
SEATTLE WA
98104-3586
US

IV. Provider business mailing address

PO BOX 26947
SALT LAKE CITY UT
84126-0947
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-2200
  • Fax: 206-292-7967
Mailing address:
  • Phone: 206-320-4476
  • Fax: 206-568-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60528248
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: