Basic Information
| Provider Information | |||||||||
| NPI: | 1871732537 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | WATTS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WATTS | ||||||||
| OtherFirstName: | KATHRYN | ||||||||
| OtherMiddleName: | BEATON | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 551 E HAWTHORNE RD | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992181417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062374116 | ||||||||
| FaxNumber: | 4062374125 | ||||||||
| Practice Location | |||||||||
| Address1: | 551 E HAWTHORNE RD | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992181417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094892369 | ||||||||
| FaxNumber: | 5092707070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2009 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036.121960 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 20804 | MT | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | MD61215444 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.