Provider Demographics
NPI:1801163746
Name:MIYAGI, KATE BARTON (ND)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:BARTON
Last Name:MIYAGI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:2091 E 1300 S STE 104
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2277
Mailing Address - Country:US
Mailing Address - Phone:801-783-3801
Mailing Address - Fax:385-270-9255
Practice Address - Street 1:2091 E 1300 S STE 104
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-2277
Practice Address - Country:US
Practice Address - Phone:801-783-3801
Practice Address - Fax:385-270-9255
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8648770-8919175F00000X
UT8648770-7100175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath