Provider Demographics
NPI:1851720858
Name:LOEBSACK, KATE
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:LOEBSACK
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 1:667 GRANT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-7818
Mailing Address - Country:US
Mailing Address - Phone:509-699-1538
Mailing Address - Fax:
Practice Address - Street 1:667 GRANT RD STE 3
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-7818
Practice Address - Country:US
Practice Address - Phone:509-699-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021000225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist