Provider Demographics
NPI:1396080735
Name:WEST, KATIE RENEE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:RENEE
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:PERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:11415 SE 229TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2681
Mailing Address - Country:US
Mailing Address - Phone:206-953-6282
Mailing Address - Fax:
Practice Address - Street 1:325 E PIONEER
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3265
Practice Address - Country:US
Practice Address - Phone:253-697-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602149551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical