Individual
KATHERINE FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
306 HOLTON AVE, YAKIMA, WA 98902-3208
(509) 453-1606
(509) 453-5321
Mailing address
306 HOLTON AVE, YAKIMA, WA 98902-3208
(509) 453-1606
(509) 453-5321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00020693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105 8270
—
WA
01
—
60025
GROUP HEALTH WA PROVIDER
WA
01
—
601-265-836
WASHINGTON STATE UBI
WA
01
—
91-149-2005
FEDERAL TAX ID
—
Enumeration date
05/24/2005
Last updated
06/02/2008
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