Provider Demographics
NPI:1366553711
Name:PIKE, CATHERINE ANN (ARNP, RNFA)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANN
Last Name:PIKE
Suffix:
Gender:F
Credentials:ARNP, RNFA
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:A
Other - Last Name:PIKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP, RNFA
Mailing Address - Street 1:16118 E SHORE DR
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6628
Mailing Address - Country:US
Mailing Address - Phone:425-745-4239
Mailing Address - Fax:
Practice Address - Street 1:16118 E SHORE DR
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6628
Practice Address - Country:US
Practice Address - Phone:425-745-4239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005904363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9631391Medicaid
WA9631391Medicaid