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General NPI Number Information
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NPI Number | 1457537557
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Entity Type | Organization
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Legal Business Name | KATHLEEN M. HURD MD PS
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 520 LILLY RD NE BUILDING 3
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City | OLYMPIA
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State | WA
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Zip | 98506-5102
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Country | US
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Telephone | 360-455-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 520 LILLY RD NE BUILDING 3
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City | OLYMPIA
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State | WA
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Zip | 98506-5102
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Country | US
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Telephone | 360-455-4500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHLEEN M. HURD
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Credential | M.D.
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Telephone | 360-455-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00030063
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License Number State | WA
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