Provider Demographics
NPI:1194292920
Name:RALON, KATIE BEUTLER (PA-C)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:BEUTLER
Last Name:RALON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:914 N SCOTTSDALE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-2116
Mailing Address - Country:US
Mailing Address - Phone:480-924-8382
Mailing Address - Fax:480-966-0566
Practice Address - Street 1:914 N SCOTTSDALE RD STE 104
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-2116
Practice Address - Country:US
Practice Address - Phone:480-924-8382
Practice Address - Fax:480-966-0566
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ8838363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant