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General NPI Number Information
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NPI Number | 1346843695
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Entity Type | Individual
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Provider Name | KATHRYN DOUGHERTY PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 307 S 13TH ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4100
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Country | US
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Telephone | 360-336-9757
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 E KINCAID ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-4127
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA061924
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | CA210001370
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA005376
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA61669714
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License Number State | WA
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