Provider Demographics
NPI:1831647510
Name:STEWART, KATHRYN H
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:H
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 ORCHARD PL
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1749
Mailing Address - Country:US
Mailing Address - Phone:360-671-3900
Mailing Address - Fax:360-671-0882
Practice Address - Street 1:3500 ORCHARD PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1749
Practice Address - Country:US
Practice Address - Phone:360-671-3900
Practice Address - Fax:360-671-0882
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60703191363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant