Healthcare Provider Details

I. General information

NPI: 1366353815
Provider Name (Legal Business Name): KATE L ALLEN
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: BUG ALLEN AUD

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 BRIDGEPORT WAY W STE 3D
UNIVERSITY PLACE WA
98466-4446
US

IV. Provider business mailing address

3560 BRIDGEPORT WAY W STE 3D
UNIVERSITY PLACE WA
98466-4446
US

V. Phone/Fax

Practice location:
  • Phone: 360-551-4800
  • Fax:
Mailing address:
  • Phone: 360-551-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.LD.70171080
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: