Provider Demographics
NPI:1205409711
Name:PAULEY, KATIE LORRAINE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LORRAINE
Last Name:PAULEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:LORRAINE
Other - Last Name:SINNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-0368
Mailing Address - Country:US
Mailing Address - Phone:360-709-6230
Mailing Address - Fax:
Practice Address - Street 1:3901 CAPITAL MALL DR SW STE A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8654
Practice Address - Country:US
Practice Address - Phone:360-709-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61183792363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner