Provider Demographics
NPI:1124247044
Name:GUNTHER, KATHERINE DIANE (OD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DIANE
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4957 LAKEMONT BLVD SE
Mailing Address - Street 2:STE C-4 #306
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-7801
Mailing Address - Country:US
Mailing Address - Phone:206-459-3962
Mailing Address - Fax:
Practice Address - Street 1:2041 148TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3725
Practice Address - Country:US
Practice Address - Phone:425-644-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003837152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist