MEDICARE: KATE JEWSON WHITENER CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	61202906	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740954965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE JEWSON WHITENER CPNP-PC

Provider Business Mailing Address
First Line	:	PO BOX 34703
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98124-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7424 BRIDGEPORT WAY W STE 103
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-8137
Country	:	US
Telephone Number	:	253-581-2111
Fax Number	:	253-581-2712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	11/06/2023

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