Provider Demographics
NPI:1275883241
Name:BRYAN, KAREN OGILVIE (JD, MA, LMHCA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:OGILVIE
Last Name:BRYAN
Suffix:
Gender:F
Credentials:JD, MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33305 1ST WAY SOUTH - SUITE B-203
Mailing Address - Street 2:THE CENTER FOR FAMILY AND LIFESPAN DEVELOPMENT
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003
Mailing Address - Country:US
Mailing Address - Phone:253-235-5956
Mailing Address - Fax:253-235-5957
Practice Address - Street 1:33305 1ST WAY SOUTH - SUITE B-203
Practice Address - Street 2:THE CENTER FOR FAMILY AND LIFESPAN DEVELOPMENT
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003
Practice Address - Country:US
Practice Address - Phone:253-235-5956
Practice Address - Fax:253-235-5957
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program