Provider Demographics
NPI:1265676225
Name:MCNICHOLS, KATHARINE (LSWAIC)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:MCNICHOLS
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 SPRUCE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2474
Mailing Address - Country:US
Mailing Address - Phone:206-548-3012
Mailing Address - Fax:206-461-8382
Practice Address - Street 1:5950 DELRIDGE WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1446
Practice Address - Country:US
Practice Address - Phone:206-938-1360
Practice Address - Fax:206-935-6056
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker