Provider Demographics
NPI:1316596893
Name:MCCAFFREE, KATHERINE A
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:A
Last Name:MCCAFFREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 11TH TEE DR
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1823
Mailing Address - Country:US
Mailing Address - Phone:253-312-7014
Mailing Address - Fax:
Practice Address - Street 1:1074 11TH TEE DR
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-1823
Practice Address - Country:US
Practice Address - Phone:253-312-7014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-08
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPENDING101YM0800X
WAMG61038500106H00000X
WALH61176158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist