Individual
KATE LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
660 S 200 E STE 250, SALT LAKE CITY, UT 84111-3846
(801) 359-2256
Mailing address
3015 NE OVERLOOK DR APT 735, HILLSBORO, OR 97124-7204
(907) 406-8310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12993974-1206
UT
Other
Enumeration date
05/29/2020
Last updated
09/01/2022
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