Provider Demographics
NPI:1992296842
Name:ORDON, KATHRYN MICHELLE (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:ORDON
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24080 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6801
Mailing Address - Country:US
Mailing Address - Phone:253-372-7680
Mailing Address - Fax:253-372-7681
Practice Address - Street 1:24080 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-6801
Practice Address - Country:US
Practice Address - Phone:253-372-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-27
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60858422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily