Healthcare Provider Details

I. General information

NPI: 1417753948
Provider Name (Legal Business Name): KATELYNN URBAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE URBAN

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

IV. Provider business mailing address

4612 FOWLER AVE APT 25
EVERETT WA
98203-2726
US

V. Phone/Fax

Practice location:
  • Phone: 206-901-2000
  • Fax:
Mailing address:
  • Phone: 206-851-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: