Provider Demographics
NPI:1821422015
Name:WILLIAMS, KATHLEEN L (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 S 288TH PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7910
Mailing Address - Country:US
Mailing Address - Phone:125-356-9322
Mailing Address - Fax:253-269-7453
Practice Address - Street 1:2308 S 288TH PL
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7910
Practice Address - Country:US
Practice Address - Phone:125-356-9322
Practice Address - Fax:253-269-7453
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-24
Last Update Date:2013-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00099592163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health