Provider Demographics
NPI:1972188852
Name:SMITHSON, KATIE ANN (PTA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:SMITHSON
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ANN
Other - Last Name:HILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:247 F CIR SE
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823-1946
Mailing Address - Country:US
Mailing Address - Phone:509-398-5055
Mailing Address - Fax:
Practice Address - Street 1:508 W DIVISION STREET
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823-1887
Practice Address - Country:US
Practice Address - Phone:509-754-6100
Practice Address - Fax:509-754-6112
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP161139716225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant