Provider Demographics
NPI:1932507035
Name:PRATT, CATALINA ROSE (NAC)
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:ROSE
Last Name:PRATT
Suffix:
Gender:F
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 CASCADE CIR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4136
Mailing Address - Country:US
Mailing Address - Phone:360-969-0105
Mailing Address - Fax:
Practice Address - Street 1:1246 CASCADE CIR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4136
Practice Address - Country:US
Practice Address - Phone:360-969-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60458929376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide