Provider Demographics
NPI:1174239354
Name:DAVIS, KATHERINE BURN (CO, LO)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BURN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CO, LO
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:CANNON
Other - Last Name:TURNAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:312 HARVARD AVE E APT 209
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5464
Mailing Address - Country:US
Mailing Address - Phone:864-491-0817
Mailing Address - Fax:
Practice Address - Street 1:411 12TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-328-4276
Practice Address - Fax:206-328-1037
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAORTH.OI.61377808222Z00000X
224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist