MCKENNA E PHILLABAUM (NPI# 1407406671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407406671 |
| Entity Type | Individual |
| Full Name | MCKENNA E PHILLABAUM |
| Practice Address |
2600 Sw Holden St Seattle WA 98126-3505 |
| Mailing Address |
4568 34th Ave W Seattle WA 98199-1133 |
| Practice Telephone | 2062488226 |
| Mailing Telephone | 2539706697 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2600 SW HOLDEN ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98126-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194728105 | Navos | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2005-05-23 |
| 1285234823 | Cardett E Geohagen | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-30 |
| 1245838192 | Victoria Chambers | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-13 |
| 1093313876 | Baylee Elizabeth Bortz | Registered Nurse | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-10-13 |
| 1821605668 | Ciera Coyan | Student in an Organized Health Care Education/Training Program | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-25 |
| 1609482736 | Jude Walker | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-23 |
| 1316553555 | Blake Aubery Phillips | Technician, Pathology | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-22 |
| 1962018192 | Sean Ambrose | Student in an Organized Health Care Education/Training Program | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-22 |
| 1285249060 | Michael Anthony Trujillo | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-09 |
| 1013521251 | Joyce Kristine Aquino | Counselor | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2020-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750926341 | Andre L Cherry | Counselor | Navos - West Seattle, 2600 Sw Holden St, Seattle, WA 98126 | 2019-11-07 |
| 1477071314 | Hailey Justine Long | Registered Nurse | 5444 29th Ave Sw, Seattle, WA 98126 | 2017-08-30 |
| 1952824153 | Margaret Jane Oliver | Behavior Technician | 7942 29th Ave Sw, Seattle, WA 98126 | 2017-07-19 |
| 1538610282 | Kathleen Unterreiner Licsw | Community/Behavioral Health | 3261 Sw Avalon Way, Apt 411, Seattle, WA 98126 | 2016-10-18 |
| 1689123507 | Omotade Adeola Mallum | Occupational Therapy Assistant | 9408 35th Ave Sw, Unit B, Seattle, WA 98126 | 2016-10-04 |
| 1598211732 | Christopher Shawn Osler | Physical Therapy Assistant | 7346 32nd Ave Sw, Seattle, WA 98126 | 2016-08-28 |
| 1871989368 | Sara Lynne Smith | Counselor | 5225 35th Avenue South West, Seattle, WA 98126 | 2015-04-10 |
| 1689083032 | Kristine Ellyn Highlander | Nurse Practitioner | 2600 Sw Holden St., Navos Inpatient Services, Seattle, WA 98126 | 2014-08-11 |
| 1346657814 | Buu Bui | Family Medicine | 4550 Fauntleroy Way Sw # Ms 206-01, Seattle, WA 98126 | 2014-07-16 |
| 1598015950 | Kimberly Pendergrass | Social Worker | 2600 S. W. Holden Street, Seattle, WA 98126 | 2012-09-13 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342358 | Emma Peconga | Student in an Organized Health Care Education/Training Program | 3619 Ashworth Ave N, Seattle, WA 98103-8116 | 2020-10-02 |
| 1780290361 | Compassionate Peer Counseling LLC | Student in an Organized Health Care Education/Training Program | 3250 Airport Way S Ste 608, Seattle, WA 98134-2172 | 2020-09-19 |
| 1336751684 | Binabahen Shah | Student in an Organized Health Care Education/Training Program | 6035 4th Ave Nw, Seattle, WA 98107-2109 | 2020-08-18 |
| 1316558968 | Jimmy Nguyen | Student in an Organized Health Care Education/Training Program | 5525 23rd Ave S, Seattle, WA 98108-2918 | 2020-08-16 |
| 1174133672 | Selomie Habtemichael | Student in an Organized Health Care Education/Training Program | 10000 30th Ave Sw, Seattle, WA 98146-3720 | 2020-08-09 |
| 1659980720 | Joseph Banham | Student in an Organized Health Care Education/Training Program | 12057 Lakeside Pl Ne, Seattle, WA 98125-5956 | 2020-07-24 |
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1659993723 | Caroline Mullins | Student in an Organized Health Care Education/Training Program | 701 N 36th St Ste 3000, Seattle, WA 98103-8868 | 2020-05-12 |
| 1730700741 | Christian Van Rooyen | Student in an Organized Health Care Education/Training Program | 1951 Pacific Street, Seattle, WA 98195 | 2020-04-30 |
| 1669092128 | Ahmed Abdelrazek | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, 356560, Department of Psychiart, Seattle, WA 98195-6560 | 2020-04-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.