Provider Demographics
NPI:1083865091
Name:OLVER-THOMPSON, CATHERINE
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:OLVER-THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:THORP
Mailing Address - State:WA
Mailing Address - Zip Code:98946-0124
Mailing Address - Country:US
Mailing Address - Phone:253-335-9805
Mailing Address - Fax:
Practice Address - Street 1:160 FIRST ST
Practice Address - Street 2:
Practice Address - City:THORP
Practice Address - State:WA
Practice Address - Zip Code:98946-0124
Practice Address - Country:US
Practice Address - Phone:253-335-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RC60056588101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor