Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 44873 | WY |
NPI | 1003450800 |
---|---|
Provider Name | Katie Aldrich |
First Address | Shelton, WA 98584-5001 |
Second Address | Shelton, WA 98584-2077 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2019 |
Last Update Date | 03/02/2021 |