Basic Information
| Provider Information | |||||||||
| NPI: | 1861857468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEUTCHER | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.B.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3817 CONSTITUTION DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799221368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152260367 | ||||||||
| FaxNumber: | 9152329953 | ||||||||
| Practice Location | |||||||||
| Address1: | 3817 CONSTITUTION DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799221368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152260367 | ||||||||
| FaxNumber: | 9152329953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2015 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA60597648 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | 106S00000X | RBT-21-157071 | TX | Y |
No ID Information.