Provider Demographics
NPI:1427175231
Name:BATEMAN, KATHY J (DC)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:J
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 ELGER BAY RD
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8375
Mailing Address - Country:US
Mailing Address - Phone:360-387-4502
Mailing Address - Fax:360-387-4502
Practice Address - Street 1:1283 ELGER BAY RD
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8375
Practice Address - Country:US
Practice Address - Phone:360-387-4502
Practice Address - Fax:360-387-4502
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001950111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician