Provider Demographics
NPI:1477063063
Name:GUZMAN, KATARINA (ND, LMT)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:ND, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15530 BOTHELL WAY NE APT 204
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-6744
Mailing Address - Country:US
Mailing Address - Phone:541-406-0550
Mailing Address - Fax:
Practice Address - Street 1:634 7TH AVE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5665
Practice Address - Country:US
Practice Address - Phone:541-406-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60791828225700000X
WANT61230599175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist