Provider Demographics
NPI:1205196128
Name:BURKE, KATHERINE (MA, PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MA, PSYD, LMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21907 64TH AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-6200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 2ND AVE W
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3928
Practice Address - Country:US
Practice Address - Phone:253-514-2346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60766336106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist