Provider Demographics
NPI:1932759990
Name:KINSEY, KATOYA UNIQUE (MA 60880034)
Entity Type:Individual
Prefix:
First Name:KATOYA
Middle Name:UNIQUE
Last Name:KINSEY
Suffix:
Gender:F
Credentials:MA 60880034
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 NW 161ST ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1218
Mailing Address - Country:US
Mailing Address - Phone:206-679-3590
Mailing Address - Fax:
Practice Address - Street 1:2033 6TH AVE FL 9
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2573
Practice Address - Country:US
Practice Address - Phone:206-326-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA608800342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer