Provider Demographics
NPI:1992000988
Name:DEGEORGE, CATHERINE ANN (EAMP, LAC, CPHT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:DEGEORGE
Suffix:
Gender:F
Credentials:EAMP, LAC, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18528 FIRLANDS WAY N
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3985
Mailing Address - Country:US
Mailing Address - Phone:339-225-0650
Mailing Address - Fax:206-546-6022
Practice Address - Street 1:18528 FIRLANDS WAY N
Practice Address - Street 2:SUITE B
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3985
Practice Address - Country:US
Practice Address - Phone:339-225-0650
Practice Address - Fax:206-546-6022
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60204433171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist