Provider Demographics
NPI:1053023846
Name:MATTAX, KATHERINE ELIZABETH GASTON (ND)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELIZABETH GASTON
Last Name:MATTAX
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 24TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5214
Mailing Address - Country:US
Mailing Address - Phone:417-860-5068
Mailing Address - Fax:
Practice Address - Street 1:5470 SHILSHOLE AVE NW STE 500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4040
Practice Address - Country:US
Practice Address - Phone:206-279-6390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath