Provider Demographics
NPI:1346644481
Name:STANTON-NURSE, MARY KATE (LMFTA)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATE
Last Name:STANTON-NURSE
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:KATE
Other - Last Name:SIMPSON-STANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13543 BURKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7712
Mailing Address - Country:US
Mailing Address - Phone:206-412-5441
Mailing Address - Fax:
Practice Address - Street 1:17839 AURORA AVE N ROOM 206
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3615
Practice Address - Country:US
Practice Address - Phone:206-454-3916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60682412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist