Provider Demographics
NPI:1386001865
Name:KATHERINE M. MCKINNEY DDS, PS.
Entity Type:Organization
Organization Name:KATHERINE M. MCKINNEY DDS, PS.
Other - Org Name:DENTISTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-284-0515
Mailing Address - Street 1:5726 LAKE WASHINGTON BLVD NE STE 2
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7425
Mailing Address - Country:US
Mailing Address - Phone:425-284-0515
Mailing Address - Fax:
Practice Address - Street 1:5726 LAKE WASHINGTON BLVD NE STE 2
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7425
Practice Address - Country:US
Practice Address - Phone:425-284-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty