Provider Demographics
NPI:1437119443
Name:PIETZ, KATHARINE MARIE (MED, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:MARIE
Last Name:PIETZ
Suffix:
Gender:F
Credentials:MED, LAT, ATC
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:MARIE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 641410
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99164-1410
Mailing Address - Country:US
Mailing Address - Phone:509-335-6230
Mailing Address - Fax:
Practice Address - Street 1:1025 SW MARCIA DR
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5253
Practice Address - Country:US
Practice Address - Phone:509-335-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer