Provider Demographics
NPI:1275519712
Name:WHIPPLE, KATHERINE JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JOY
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3649
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-3649
Mailing Address - Country:US
Mailing Address - Phone:509-838-2531
Mailing Address - Fax:
Practice Address - Street 1:4815 N ASSEMBLY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6185
Practice Address - Country:US
Practice Address - Phone:509-999-4835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072950207R00000X, 208000000X
WAMD00044128208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
8866167OtherMEDICARE PART B
WA222566OtherL&I
WA7034093Medicaid
WA7138348Medicaid
WA8454936Medicaid
8866166OtherMEDICARE PART B
8866169OtherMEDICARE PART B
8866164OtherMEDICARE PART B
WA7034077Medicaid
WA7034127Medicaid
WA501808Medicare Oscar/Certification
WA8454936Medicaid
8866167OtherMEDICARE PART B
WA501813Medicare Oscar/Certification