Provider Demographics
NPI:1316508864
Name:THOUNE, KATELYN S
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:S
Last Name:THOUNE
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 1:820 NE 96TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3365
Mailing Address - Country:US
Mailing Address - Phone:360-949-0355
Mailing Address - Fax:
Practice Address - Street 1:820 NE 96TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3365
Practice Address - Country:US
Practice Address - Phone:360-949-0355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician