| Katies Way Dupont | |
|
1175 Center Dr Ste 130 Dupont WA 98327-7733 | |
| (253) 260-6521 | |
| (253) 397-3443 |
| Full Name | Katies Way Dupont |
|---|---|
| Speciality | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry |
| Location | 1175 Center Dr Ste 130, Dupont, Washington |
| Authorized Official Name and Position | Kelly Rae Johnson (CREDENTIALING DIRECTOR) |
| Authorized Official Contact | 7853206616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katies Way Dupont 1175 Center Dr Ste 130 Dupont WA 98327-7733 Ph: (253) 260-6521 | Katies Way Dupont 1175 Center Dr Ste 130 Dupont WA 98327-7733 Ph: (253) 260-6521 |
| NPI Number | 1518773035 |
|---|---|
| Provider Enumeration Date | 12/09/2024 |
| Last Update Date | 12/09/2024 |
| Certification Date | 12/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518773035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
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