Individual
CATHERINE GRACE ENGIBOUS HOLDER
Active
Individual
CATHERINE GRACE ENGIBOUS HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60511351
WA
363AM0700X
Medical Physician Assistant
PA60511351
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60511351
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K163676
PTAN
—
05
—
MDA0380
—
AK
Enumeration date
05/27/2010
Last updated
07/30/2021
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