Provider Demographics
NPI:1902685316
Name:KOZOWSKI, KATHRYN (ND, LAC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KOZOWSKI
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18321 STONE AVE N APT 4
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4532
Mailing Address - Country:US
Mailing Address - Phone:360-510-4794
Mailing Address - Fax:
Practice Address - Street 1:119 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2955
Practice Address - Country:US
Practice Address - Phone:360-863-3223
Practice Address - Fax:888-875-1198
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171100000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist