Individual
KATHLEEN ANNE WIRTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1655 HUDSON ST STE 1, LONGVIEW, WA 98632-2949
(360) 749-0010
(844) 654-7171
Mailing address
PO BOX 48, CARROLLS, WA 98609-0048
(360) 749-0010
(360) 425-0861
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
AP60184972
WA
367A00000X
Advanced Practice Midwife
Primary
AP60172230
WA
Other
Enumeration date
07/28/2010
Last updated
04/23/2018
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