Provider Demographics
NPI:1225750508
Name:ASHE, KATIE MAY (CO61354716)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MAY
Last Name:ASHE
Suffix:
Gender:F
Credentials:CO61354716
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98577-2699
Mailing Address - Country:US
Mailing Address - Phone:360-942-2474
Mailing Address - Fax:
Practice Address - Street 1:1016 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:WA
Practice Address - Zip Code:98577-2631
Practice Address - Country:US
Practice Address - Phone:360-942-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61354716101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)