Provider Demographics
NPI:1790493013
Name:NUNNELEE, KATHERINE (EAMP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:NUNNELEE
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W BROADWAY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1819
Mailing Address - Country:US
Mailing Address - Phone:509-842-6172
Mailing Address - Fax:
Practice Address - Street 1:1801 W BROADWAY AVE STE 1
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1819
Practice Address - Country:US
Practice Address - Phone:509-838-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61365635171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty