Individual
KATHRYN MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
33915 1ST WAY S, STE 200, FEDERAL WAY, WA 98003-4551
(253) 838-9839
(253) 661-9077
Mailing address
3209 S 23RD ST, STE 340, TACOMA, WA 98405-1602
(253) 383-8342
(253) 572-8204
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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