Provider Demographics
NPI:1306968490
Name:KATZ, JOANNA LYNN (NP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:LYNN
Last Name:KATZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 77814
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-0814
Mailing Address - Country:US
Mailing Address - Phone:425-774-5163
Mailing Address - Fax:425-744-1705
Practice Address - Street 1:21701 76TH AVE W
Practice Address - Street 2:SUITE 203
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7536
Practice Address - Country:US
Practice Address - Phone:425-774-5163
Practice Address - Fax:425-744-1705
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR153755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily