Provider Demographics
NPI:1235278854
Name:O'ROURKE, KATHLEEN SHARON (CRNFA)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:SHARON
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13610 NE 22ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6801
Mailing Address - Country:US
Mailing Address - Phone:360-694-7211
Mailing Address - Fax:360-750-1124
Practice Address - Street 1:3333 N WHITMAN ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-1547
Practice Address - Country:US
Practice Address - Phone:253-759-3065
Practice Address - Fax:253-759-2585
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00064881163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant