Individual
KATIE WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 268-6976
(316) 291-4396
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9769
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
05-36623
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719275
KANSAS MEDICARE
KS
01
—
200313290A
OKLAHOMA MEDICARE
OK
05
—
201075920A
—
KS
Enumeration date
07/08/2009
Last updated
04/30/2015
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