# MISS KERRY LAUREN WITHERELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790971695
- **Gender:** F
- **Credential:** AU.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | LD00004703 | WA | Yes |

## Other

- **Enumeration date:** 09/24/2007
- **Last updated:** 05/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8501983 | — | WA |
| 01 | — | 8719WI | BLUE SHIELD \# | WA |
| 01 | — | P00444843 | RAILROAD MC \# | WA |