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General NPI Number Information
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NPI Number | 1932562071
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Entity Type | Individual
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Provider Name | KATHARINE TSUKAHARA
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Gender | Female
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 81 N MARIO CAPECCHI DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84113-1125
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Country | US
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Telephone | 801-213-3599
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | MT217486
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 12868437-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD468242
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License Number State | PA
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