Black, Catherine C

Black, Catherine C is an individual health care provider with primary practice located at 808 Port Dr , Clarkston WA 99403-6009. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Black, Catherine C can be contacted via phone (509) 455-8820.

Contact Information

Primary practice address
808 Port Dr Clarkston WA 99403-6009
Phone: (509) 455-8820
Fax: (509) 838-4978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA159129 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7072 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10004690 Washington
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA10004690 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10004690 Washington

Profile Details

NPI number 1780613018
LBN Legal business name Black, Catherine C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Aug 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780613018 NPPES
Washington Other 0194214 L&I
Washington MEDICAID 8415937 L&I
Washington MEDICAID 500648665 L&I

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