Provider Demographics
NPI:1083238745
Name:WIKEN, KATHERINE ROSE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE
Last Name:WIKEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:EVERED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12303 NE 130TH LN STE 500
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3059
Mailing Address - Country:US
Mailing Address - Phone:425-899-4280
Mailing Address - Fax:425-899-4294
Practice Address - Street 1:12303 NE 130TH LANE, CORAL 500
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-899-4280
Practice Address - Fax:425-899-4294
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60756278163W00000X
WAAP61177342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse