Provider Demographics
NPI:1932141959
Name:STEIN, KATHLEEN E (DO)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:STEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:1601 SE COURT AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3217
Practice Address - Country:US
Practice Address - Phone:541-276-5121
Practice Address - Fax:541-278-3661
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORDO11326207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR023796Medicaid
WA8101651Medicaid
ORR131326Medicare PIN
WA8101651Medicaid
OR023796Medicaid