Provider Demographics
NPI:1801055710
Name:HIMES, MARY KATE (PTA)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATE
Last Name:HIMES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HIMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:2540 26TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-7039
Mailing Address - Country:US
Mailing Address - Phone:253-939-0090
Mailing Address - Fax:
Practice Address - Street 1:502 29TH ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-7532
Practice Address - Country:US
Practice Address - Phone:253-939-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant