Provider Demographics
NPI:1366003287
Name:KAATZ, KATHRYN
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:KAATZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KAT
Other - Middle Name:
Other - Last Name:KAATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:690 CRANBERRY DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9705
Mailing Address - Country:US
Mailing Address - Phone:850-449-0717
Mailing Address - Fax:
Practice Address - Street 1:32650 STATE ROUTE 20 STE 204
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-2641
Practice Address - Country:US
Practice Address - Phone:360-279-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician