Provider Demographics
NPI:1083916597
Name:MORIARTY, KATHERINE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LYNN
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5328
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387
Mailing Address - Country:US
Mailing Address - Phone:253-797-2360
Mailing Address - Fax:
Practice Address - Street 1:3500 NW BUCKLIN HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8503
Practice Address - Country:US
Practice Address - Phone:360-832-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60184334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor