Doctor Name: | KATHERINE COUSINEAU |
NPI Number: | 1114312402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 518 W 1st Ave Toppenish, WA - 989481564 |
Business Phone Number: | 5098655600 |
Business Fax Number: | 5098655783 |
Mailing Address: | Po Box 190, TOPPENISH |
State: | WA |
Postal Code: | 989480190 |
Phone Number: | 5098652395 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2015 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |