Provider Demographics
NPI:1356539399
Name:STORY, KATHRYN ALBRIGHT (RDH,BS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALBRIGHT
Last Name:STORY
Suffix:
Gender:F
Credentials:RDH,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-9512
Mailing Address - Country:US
Mailing Address - Phone:509-783-6087
Mailing Address - Fax:
Practice Address - Street 1:7102 W OKANOGAN PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2341
Practice Address - Country:US
Practice Address - Phone:509-460-4253
Practice Address - Fax:509-460-4515
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00002571124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5902515Medicaid