Provider Demographics
NPI:1154650695
Name:OSBORN, CAREN LEE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:LEE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 39TH AVE SW STE 304
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3805
Mailing Address - Country:US
Mailing Address - Phone:253-368-8912
Mailing Address - Fax:253-697-6547
Practice Address - Street 1:1002 39TH AVE SW STE 304
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3805
Practice Address - Country:US
Practice Address - Phone:253-368-8912
Practice Address - Fax:253-697-6547
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001860106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist