Provider Demographics
NPI:1528161650
Name:HUME, KATHERINE (LMP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:HUME
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:HUME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA00020846 MPL
Mailing Address - Street 1:520 NW 12TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-3991
Mailing Address - Country:US
Mailing Address - Phone:360-687-2304
Mailing Address - Fax:
Practice Address - Street 1:1111 N NORTHGATE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8913
Practice Address - Country:US
Practice Address - Phone:206-523-2225
Practice Address - Fax:206-523-9101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020846225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist