Provider Demographics
NPI:1558308064
Name:CARR, KATHERINE A (CNM, ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:CARR
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:CAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, ARNP
Mailing Address - Street 1:PO BOX 34876
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1876
Mailing Address - Country:US
Mailing Address - Phone:425-656-5412
Mailing Address - Fax:425-656-4096
Practice Address - Street 1:4033 TALBOT RD S
Practice Address - Street 2:STE 440
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5772
Practice Address - Country:US
Practice Address - Phone:425-656-5321
Practice Address - Fax:425-656-5319
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000164367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife