Provider Demographics
NPI:1316529993
Name:WASHBURN, KATHRYN (RN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WASHBURN
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 1:19906 68TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-5613
Mailing Address - Country:US
Mailing Address - Phone:208-870-9513
Mailing Address - Fax:
Practice Address - Street 1:19906 68TH AVE E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-5613
Practice Address - Country:US
Practice Address - Phone:208-870-9513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00165198163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse