Provider Demographics
NPI:1760673750
Name:SALISBURY, KATHLEEN WYNN (MPH, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:WYNN
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:MPH, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10517 70TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8506
Mailing Address - Country:US
Mailing Address - Phone:253-298-6898
Mailing Address - Fax:
Practice Address - Street 1:10517 70TH AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8506
Practice Address - Country:US
Practice Address - Phone:253-405-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No174400000XOther Service ProvidersSpecialist