Provider Demographics
NPI:1912317744
Name:SNYDER, KATHERINE LEE (DNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:CALMA
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:467 SW CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2915
Mailing Address - Country:US
Mailing Address - Phone:602-920-3517
Mailing Address - Fax:
Practice Address - Street 1:315 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4234
Practice Address - Country:US
Practice Address - Phone:253-403-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60087477163W00000X
AZRN167050163W00000X
WAAP60491309363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse