Provider Demographics
NPI:1982246039
Name:PRENDERGAST, KALEIGH KATHLEEN (PA)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:KATHLEEN
Last Name:PRENDERGAST
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Gender:F
Credentials:PA
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Mailing Address - Street 1:618 PEARL POINT CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1575
Mailing Address - Country:US
Mailing Address - Phone:410-303-6187
Mailing Address - Fax:
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:206-326-2785
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2022-04-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant