Genova, Katelyn Rae

Genova, Katelyn Rae is an individual health care provider with primary practice located at 3801 5Th St Se Ste 110 , Puyallup WA 98374-2106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Genova, Katelyn Rae can be contacted via phone (253) 845-9585.

Contact Information

Primary practice address
3801 5Th St Se Ste 110 Puyallup WA 98374-2106
Phone: (253) 845-9585
Fax: (253) 848-1126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA61579562 Washington

Profile Details

NPI number 1083206973
LBN Legal business name Genova, Katelyn Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2021
Last updated Oct 31st, 2025 - about last year

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 1083206973 NPPES
Washington MEDICAID 2348579

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