Provider Demographics
NPI:1134478936
Name:O'BRIEN, KAREN MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MICHELLE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 W HAYES ST
Mailing Address - Street 2:JOINT BASE LEWIS-MCCHORD
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-312-3608
Mailing Address - Fax:
Practice Address - Street 1:9933 W HAYES ST
Practice Address - Street 2:JOINT BASE LEWIS-MCCHORD
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-312-3608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60317258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical