Basic Information
Provider Information
NPI: 1023178886
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEATTIE
FirstName: CATHERINE
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 24366
Address2: MS 359107
City: SEATTLE
State: WA
PostalCode: 981240366
CountryCode: US
TelephoneNumber: 2065980502
FaxNumber: 2065980516
Practice Location
Address1: 1959 NE PACIFIC ST.
Address2: BOX 356159
City: SEATTLE
State: WA
PostalCode: 98195
CountryCode: US
TelephoneNumber: 2065988130
FaxNumber: 2065982359
Other Information
ProviderEnumerationDate: 12/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
170300000X  Y Other Service ProvidersGenetic Counselor, MS 

No ID Information.


Home