Basic Information
| Provider Information | |||||||||
| NPI: | 1861934218 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DENTEL | ||||||||
| FirstName: | KATHRIN | ||||||||
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| Credential: | A.R.N.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15520 SE 229TH PL | ||||||||
| Address2: | |||||||||
| City: | KENT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980424010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066975467 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26401 PACIFIC HWY S | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981989247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538337444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2016 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP60973014 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 163W00000X | RN60416197 | WA | N | Nursing Service Providers | Registered Nurse |
No ID Information.