Individual
KATHLEEN A MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11511 CANTERWOOD BLVD STE 205, GIG HARBOR, WA 98332-5818
(253) 530-2663
Mailing address
11511 CANTERWOOD BLVD STE 205, GIG HARBOR, WA 98332-5818
(253) 530-2663
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003808
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201042
STATE L&I
WA
01
—
0201048
STATE L&I
WA
05
—
1042578
—
WA
Enumeration date
08/05/2006
Last updated
12/07/2020
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