Provider Demographics
NPI:1639157613
Name:ARENDT, KATHRYN LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LOUISE
Last Name:ARENDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 116TH AVE NE
Mailing Address - Street 2:SUITE 620
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-454-8016
Mailing Address - Fax:425-453-2827
Practice Address - Street 1:12815 120TH AVE NE STE E
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3003
Practice Address - Country:US
Practice Address - Phone:425-454-8016
Practice Address - Fax:425-453-2827
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031752207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1015140Medicaid
WAF89615Medicare UPIN
WA1015140Medicaid