Provider Demographics
NPI:1285769117
Name:DOUGLASS, KAREN ELIZABETH GOODWIN (MA, LMHC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH GOODWIN
Last Name:DOUGLASS
Suffix:
Gender:F
Credentials:MA, LMHC
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 1854
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-1854
Mailing Address - Country:US
Mailing Address - Phone:425-417-3130
Mailing Address - Fax:425-888-1344
Practice Address - Street 1:38700 RIVER ST SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065
Practice Address - Country:US
Practice Address - Phone:425-417-3130
Practice Address - Fax:425-888-1344
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health