Basic Information
Provider Information
NPI: 1386201267
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKAY
FirstName: KARA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: DNP, ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3541 MERIDIAN AVE N
Address2:  
City: SEATTLE
State: WA
PostalCode: 981039121
CountryCode: US
TelephoneNumber: 2092062191
FaxNumber:  
Practice Location
Address1: 2505 2ND AVE STE 200
Address2:  
City: SEATTLE
State: WA
PostalCode: 981211495
CountryCode: US
TelephoneNumber: 2064430400
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/25/2019
LastUpdateDate: 05/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP60957110WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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