Provider Demographics
NPI:1710167176
Name:WINBORN, KATHERINE JARRETT (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JARRETT
Last Name:WINBORN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84026
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-8426
Mailing Address - Country:US
Mailing Address - Phone:206-320-5510
Mailing Address - Fax:206-320-5522
Practice Address - Street 1:3400 CALIFORNIA AVE SW
Practice Address - Street 2:STE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3307
Practice Address - Country:US
Practice Address - Phone:206-320-5510
Practice Address - Fax:206-320-5522
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00010438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8498784Medicaid
WA8498784Medicaid