Provider Demographics
NPI:1306305289
Name:SCOTT, KATHRYN SUSANNE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:SUSANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW, LICSW
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Other - Middle Name:
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Mailing Address - Street 1:ATTN: KATHRYN SCOTT, V3CNH
Mailing Address - Street 2:1601 E. FOURTH PLAIN BLVD.
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661
Mailing Address - Country:US
Mailing Address - Phone:360-696-4061
Mailing Address - Fax:360-690-0343
Practice Address - Street 1:ATTN: KATHRYN SCOTT, V3CNH
Practice Address - Street 2:1601 E. FOURTH PLAIN BLVD.
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661
Practice Address - Country:US
Practice Address - Phone:360-696-4061
Practice Address - Fax:360-690-0343
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW605471871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical