Provider Demographics
NPI:1083757652
Name:KAWAMOTO, CATHY Y (MD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:Y
Last Name:KAWAMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2354
Mailing Address - Country:US
Mailing Address - Phone:206-721-5600
Mailing Address - Fax:
Practice Address - Street 1:5316 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2354
Practice Address - Country:US
Practice Address - Phone:206-721-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8357477Medicaid
WAH94922Medicare UPIN
WAGAB39514Medicare PIN
WAG8850232Medicare PIN
WAP00205632Medicare PIN
WAG8850228Medicare PIN
WAG8850234Medicare PIN
WAG8850233Medicare PIN