Provider Demographics
NPI:1699898817
Name:MAGEE, KATHERINE (MD)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:MAGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 NORTH 2ND AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864
Mailing Address - Country:US
Mailing Address - Phone:208-265-2242
Mailing Address - Fax:208-265-8214
Practice Address - Street 1:420 NORTH 2ND AVE
Practice Address - Street 2:STE 100
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864
Practice Address - Country:US
Practice Address - Phone:208-265-2242
Practice Address - Fax:208-265-8214
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT185962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics