Provider Demographics
NPI:1245610443
Name:GINGERICH, KATHRYN JANE (LMFTA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JANE
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:JANE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFTA
Mailing Address - Street 1:6478 NE 135TH PL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1626
Mailing Address - Country:US
Mailing Address - Phone:425-260-8491
Mailing Address - Fax:424-823-3709
Practice Address - Street 1:11417 124TH AVE NE
Practice Address - Street 2:SUITE 204
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4677
Practice Address - Country:US
Practice Address - Phone:425-889-0832
Practice Address - Fax:425-823-3709
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG 60176078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health