Provider Demographics
NPI:1306998869
Name:DAHL, CATHERINE MARIE (CDP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARIE
Last Name:DAHL
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:MARIE
Other - Last Name:WERDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CDP
Mailing Address - Street 1:14915 38TH DR SE
Mailing Address - Street 2:HH-1029
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4200
Mailing Address - Country:US
Mailing Address - Phone:425-258-5277
Mailing Address - Fax:425-258-5275
Practice Address - Street 1:1114 PACIFIC AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4231
Practice Address - Country:US
Practice Address - Phone:425-258-5277
Practice Address - Fax:425-258-5275
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003220101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)