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Individual
KATHRYN MARIE PHILLIPS
Active
Individual
KATHRYN MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.60490709
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2044171
—
WA
01
—
G000188100
GROUP PTAN(K)
WA
01
—
G001045700
GROUP PTAN(P)
WA
Enumeration date
09/29/2014
Last updated
12/09/2019
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