Provider Demographics
NPI:1174014799
Name:PATEL, KATHERINE OLSEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:OLSEN
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:CONSTANCE
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 MASSACHUSETTS AVE NW APT 622
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-6808
Mailing Address - Country:US
Mailing Address - Phone:803-767-5082
Mailing Address - Fax:
Practice Address - Street 1:1221 MERCANTILE LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5374
Practice Address - Country:US
Practice Address - Phone:803-767-5082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPHI100003061183500000X
VA0202216420183500000X
MD24966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist