Provider Demographics
NPI:1073104857
Name:SAUNDERS-KOSTA, KATELYNN J (MA, LMHCA)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:J
Last Name:SAUNDERS-KOSTA
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S RIVER AVE UNIT 950
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-4038
Mailing Address - Country:US
Mailing Address - Phone:253-987-5610
Mailing Address - Fax:
Practice Address - Street 1:314182 AVE E SUITE C
Practice Address - Street 2:
Practice Address - City:LAKE TAPPES
Practice Address - State:WA
Practice Address - Zip Code:98391
Practice Address - Country:US
Practice Address - Phone:253-987-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health