Provider Demographics
NPI:1235210899
Name:BROGDON, KATHERINE ELAINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELAINE
Last Name:BROGDON
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 1:1660 SOUTH COLUMBIAN WAY, MS 111
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1597
Mailing Address - Country:US
Mailing Address - Phone:206-277-4200
Mailing Address - Fax:206-764-2936
Practice Address - Street 1:1660 SOUTH COLUMBIAN WAY, MS 111
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1597
Practice Address - Country:US
Practice Address - Phone:206-277-4200
Practice Address - Fax:206-764-2936
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003253363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health