Provider Demographics
NPI:1962486506
Name:KATZENBERGER, ANN E (OD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:KATZENBERGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5409
Mailing Address - Country:US
Mailing Address - Phone:253-833-5000
Mailing Address - Fax:253-735-0400
Practice Address - Street 1:224 E MAIN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5409
Practice Address - Country:US
Practice Address - Phone:253-833-5000
Practice Address - Fax:253-735-0400
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3727152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist