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General NPI Number Information
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NPI Number | 1346883378
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Entity Type | Organization
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Legal Business Name | KATIE KERN PMHNP
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 707 S GRADY WAY STE 600
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City | RENTON
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State | WA
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Zip | 98057-3227
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Country | US
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Telephone | 206-338-5303
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Fax |
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Provider Business Mailing Address
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Address Line | 707 S GRADY WAY STE 600
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City | RENTON
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State | WA
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Zip | 98057-3227
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Country | US
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Telephone | 206-338-5303
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KATIE ROSE KERN
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Credential | ARNP
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Telephone | 206-338-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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