MS. KATHRYN P HACKNEY PAC
NPI 1639166176
Physician Assistant - Medical in Shelton, WA

Q: What is Kathryn Hackney's NPI number?

The NPI number for Kathryn Hackney is 1639166176. It was assigned to this individual provider in the NPPES registry on September 30, 2005. The provider is also known as Ms. Katie N Privette Hackney Pa-C.

Q: What is Kathryn Hackney's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kathryn Hackney was last updated on February 23, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 30, 2005PECOS Enrolled

237 PROFESSIONAL WAY, SHELTON, WA 98584(360) 426-2500(360) 462-2500 Get Directions Write a Review

NPPES record last updated: February 23, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Ms. Kathryn P Hackney Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KATHRYN P HACKNEY PAC (NPI 1639166176) is an individual medical provider in Shelton, Washington, licensed in Washington (PA10004637) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639166176

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. KATHRYN P HACKNEYCredential: PAC

Location Address237 PROFESSIONAL WAYShelton, WA 98584-4404

Mailing Address237 Professional WayShelton, WA 98584-4404 · (360) 426-2500 · Fax (360) 462-2500

Phone(360) 426-2500

Fax(360) 462-2500

Sole ProprietorNo

Enumeration DateSeptember 30, 2005

Last NPPES UpdateFebruary 23, 2012

✔ NPI 1639166176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in WA · PA10004637

237 PROFESSIONAL WAY, Shelton, WA 98584

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Other Names 1

Former Name (1)Ms. Katie N Privette Hackney Pa-c

Other Identifiers 1

Medicaid8402349WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kathryn P Hackney Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier11 claims11 services$215.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IN KYU YOO M.D.

Internal Medicine