Provider Demographics
NPI:1992128029
Name:RATLEY, CAROLYN (LMFT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:RATLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 BRIDGEPORT WAY W # D5
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4598
Mailing Address - Country:US
Mailing Address - Phone:206-588-5140
Mailing Address - Fax:
Practice Address - Street 1:3318 BRIDGEPORT WAY W # D5
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4598
Practice Address - Country:US
Practice Address - Phone:206-588-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist