Provider Demographics
NPI:1164716304
Name:JABLONSKI, KATE B
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:B
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:B
Other - Last Name:WIDTFELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:5000 CHESHIRE PKWY N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-4103
Mailing Address - Country:US
Mailing Address - Phone:763-268-4388
Mailing Address - Fax:763-268-4017
Practice Address - Street 1:1038 116TH AVE NE
Practice Address - Street 2:STE 330
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4621
Practice Address - Country:US
Practice Address - Phone:425-455-5596
Practice Address - Fax:425-451-3248
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60003462231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist