Provider Demographics
NPI:1306178298
Name:DR KATHLEEN M KINNEY, OD, PS
Entity Type:Organization
Organization Name:DR KATHLEEN M KINNEY, OD, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-624-0737
Mailing Address - Street 1:1511 3RD AVE
Mailing Address - Street 2:SUITE 411
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3635
Mailing Address - Country:US
Mailing Address - Phone:206-624-0737
Mailing Address - Fax:206-626-0878
Practice Address - Street 1:1511 3RD AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3635
Practice Address - Country:US
Practice Address - Phone:206-624-0737
Practice Address - Fax:206-626-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty