Provider Demographics
NPI:1720623473
Name:ROYALTY, CATHERINE REN (ARNP, RN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:REN
Last Name:ROYALTY
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:TAMERA
Other - Middle Name:CATHERINE
Other - Last Name:ROYALTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:884 W PARK AVE
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2273
Practice Address - Country:US
Practice Address - Phone:360-385-0321
Practice Address - Fax:360-379-2539
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-16
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60745213163W00000X
WAAP61065797363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse