Provider Demographics
NPI:1790004141
Name:KULA, KATIE JOLAINE (DC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JOLAINE
Last Name:KULA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:J
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1759
Mailing Address - Street 2:
Mailing Address - City:WHITE SALMON
Mailing Address - State:WA
Mailing Address - Zip Code:98672
Mailing Address - Country:US
Mailing Address - Phone:509-493-4000
Mailing Address - Fax:509-493-4001
Practice Address - Street 1:410 E JEWETT BLVD
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672-3002
Practice Address - Country:US
Practice Address - Phone:509-493-4000
Practice Address - Fax:509-493-1462
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010002023111N00000X
WACHIR.CH.60202833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor