Provider Demographics
NPI:1184654071
Name:MCMASTER, KATHRYN J (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-341-4612
Mailing Address - Fax:206-341-4614
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-341-4612
Practice Address - Fax:206-341-4614
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00084767163W00000X
WAAP30005533363L00000X, 363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA32568UOtherREGENCE BLUE SHIELD PIN
WA0189549OtherL&I PIN
WA9643479Medicaid
WA32568UOtherREGENCE BLUE SHIELD PIN
WA8851182Medicare PIN