Provider Demographics
NPI:1710568423
Name:BUCHANAN, KATHLEEN (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4933 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2828
Mailing Address - Country:US
Mailing Address - Phone:425-903-3070
Mailing Address - Fax:
Practice Address - Street 1:4933 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2828
Practice Address - Country:US
Practice Address - Phone:425-903-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date: