Provider Demographics
NPI:1003359019
Name:KEIR, CATHERINE (CL 60161867)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:KEIR
Suffix:
Gender:F
Credentials:CL 60161867
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 12TH AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2467
Mailing Address - Country:US
Mailing Address - Phone:206-818-0397
Mailing Address - Fax:
Practice Address - Street 1:1605 12TH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2467
Practice Address - Country:US
Practice Address - Phone:206-818-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL 60161867101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACL 60161867OtherCOUNSELOR CERTIFIED WASHINGTON STATE DEPARTMENT OF HEALTH