Basic Information
| Provider Information | |||||||||
| NPI: | 1679917116 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAUNHURST | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1127 WILSHIRE BLVD STE 909 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900173910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132780021 | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 OLIVE WAY | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068604691 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2013 | ||||||||
| LastUpdateDate: | 04/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A150816 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 35.127603 | OH | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | MD60931788 | WA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.