MS. KATHLEEN ANNETTE PUDERBAUGH (NPI# 1366433864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366433864 |
| Entity Type | Individual |
| Full Name | MS. KATHLEEN ANNETTE PUDERBAUGH |
| Credential | ARNP |
| Practice Address |
6760 Mission Rd Everson WA 98247-9749 |
| Mailing Address |
6432 Olson Rd Ferndale WA 98248-8514 |
| Practice Telephone | 3609662106 |
| Practice Fax Number | 3609662304 |
| Mailing Telephone | 3603830693 |
| Mailing Fax Number | 3603830838 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2011-12-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP30003425 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
AP30003425 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6760 MISSION RD |
| City | EVERSON |
| State | WA |
| Zip Code | 98247-9749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275789885 | Sandra L Stork | Counselor | 6760 Mission Rd, Everson, WA 98247-9749 | 2008-08-14 |
| 1790978229 | Cathie L Diller | Family Medicine | 6760 Mission Rd, Everson, WA 98247-9749 | 2007-08-17 |
| 1699967265 | Nooksack Indian Tribe | Dentist | 6760 Mission Rd, Everson, WA 98247-9749 | 2007-08-16 |
| 1578778189 | Nooksack Central Management System | Counselor | 6760 Mission Rd, Everson, WA 98247-9749 | 2007-05-14 |
| 1760517726 | Aamer A. Khan | Counselor | 6760 Mission Rd, Everson, WA 98247 | 2007-02-22 |
| 1891843769 | Nooksack Dental Clinic | Dentist | 6760 Mission Rd, Everson, WA 98247-9749 | 2007-01-08 |
| 1932257144 | Mary Ellen Shields | Pediatrics | 6760 Mission Rd, Everson, WA 98247-9749 | 2007-01-08 |
| 1568528842 | Nooksack Central Management System | Family Medicine | 6760 Mission Rd, Everson, WA 98247-9749 | 2006-12-29 |
| 1841351285 | Randall Moore | Family Medicine | 6760 Mission Rd, Everson, WA 98247-9749 | 2006-12-12 |
| 1730248550 | Frank Eugene James | Family Medicine | 6760 Mission Rd, Everson, WA 98247-9749 | 2006-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902352727 | Francis Pitsch | Counselor | 2505 B Sulwhanon Dr, Everson, WA 98247 | 2016-08-31 |
| 1073959524 | Candice Dorsten | Counselor | 2505 Sulwhanon Dr, Everson, WA 98247 | 2013-05-10 |
| 1881938389 | Shannon Bb Trulson | Marriage & Family Therapist | 2505 Sulwhanon Drive, Everson, WA 98247 | 2012-11-21 |
| 1679866594 | Brian Erik Aasby | Physical Therapist | 102 W. Main St., Ste 103, Everson, WA 98247 | 2011-05-25 |
| 1417278433 | Elliott Chiropractic Clinic, Pllc | Chiropractor | 111 E.main Street, Everson, WA 98247 | 2010-06-14 |
| 1851620835 | Sara Majumdar | Counselor | 2505 Sulwhanon Dr., Everson, WA 98247 | 2009-12-21 |
| 1073740585 | Whatcom County Fire Protection District No. 1 | Ambulance | 101 East Main Street, Everson, WA 98247 | 2009-06-11 |
| 1942455688 | Gimi Remedios Garcia | Counselor | 6746 Mission Rd., Everson, WA 98247 | 2008-11-21 |
| 1194947689 | Jessica Rae Claborn | Specialist | 111 E. Main St., Everson, WA 98247 | 2007-05-03 |
| 1952442881 | Scott Russell Elliott | Chiropractor | 111 E Main St.reet, Everson, WA 98247 | 2007-02-12 |
| Find all providers in zip 98247 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190835 | Women's Mobile Medical. LLC | Nurse Practitioner | 701 E 49th St, Tacoma, WA 98404-2025 | 2020-10-02 |
| 1992323018 | Megan Louise Bedker | Nurse Practitioner | 3003 80th Ave Se, Mercer Island, WA 98040-2915 | 2020-07-07 |
| 1114557196 | Scarlett Owen Duncan | Nurse Practitioner | 27121 174th Pl Se Ste 201, Covington, WA 98042-4939 | 2020-01-18 |
| 1346889250 | Kaylee Meilahn | Nurse Practitioner | 219 State Ave. N, Suite 220, Kent, WA 98030 | 2019-12-26 |
| 1508403858 | New U Women's Clinic & Aesthetics Pllc | Nurse Practitioner | 35 S Louisiana St, Suite A120, Kennewick, WA 99336 | 2019-12-05 |
| 1174008106 | Nicole Ann Bazzetta | Nurse Practitioner | 1901 S Union Ave Ste 2006, Tacoma, WA 98405-1702 | 2018-09-25 |
| 1174000178 | Emily K Ernst | Nurse Practitioner | 4525 S 19th St, Tacoma, WA 98405-1106 | 2018-07-23 |
| 1770079493 | Erica Lauren Nunez | Nurse Practitioner | 5020 Roosevelt Way Ne Ste 1, Seattle, WA 98105-3644 | 2018-07-05 |
| 1659881001 | Kathryn Conkling | Nurse Practitioner | 10210 State Ave, Marysville, WA 98271-7214 | 2017-10-11 |
| 1033575113 | Amanda Jane Holen | Nurse Practitioner | 202 State Avenue North, Kent, WA 98031 | 2016-01-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.