Provider Demographics
NPI:1992249809
Name:ALSTATT, KATHLEEN (LPN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ALSTATT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 S WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3636
Mailing Address - Country:US
Mailing Address - Phone:206-722-6249
Mailing Address - Fax:
Practice Address - Street 1:4255 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3636
Practice Address - Country:US
Practice Address - Phone:206-722-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00037886164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse