Provider Demographics
NPI:1114747136
Name:TAYLOR, KATHRYN CARLOTTA (MS, LMFTA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CARLOTTA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMFTA
Mailing Address - Street 1:3329 37TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-7015
Mailing Address - Country:US
Mailing Address - Phone:206-588-9751
Mailing Address - Fax:
Practice Address - Street 1:15446 BEL RED RD STE 401
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5507
Practice Address - Country:US
Practice Address - Phone:206-588-9751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61497658106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist