Provider Demographics
NPI:1952496226
Name:SOREM, CATHY ANN (RN)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:SOREM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 114TH ST. CT. EAST
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374
Mailing Address - Country:US
Mailing Address - Phone:253-583-1671
Mailing Address - Fax:253-589-4106
Practice Address - Street 1:9600 VETERANS DRIVE A116-R
Practice Address - Street 2:BLDG. 61A, ROOM 123
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493
Practice Address - Country:US
Practice Address - Phone:253-583-1671
Practice Address - Fax:253-589-4106
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00122345163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health