Provider Demographics
NPI:1376979187
Name:PEPPARD, CATHARINE JOHANNA (BA, MA)
Entity Type:Individual
Prefix:MRS
First Name:CATHARINE
Middle Name:JOHANNA
Last Name:PEPPARD
Suffix:
Gender:F
Credentials:BA, MA
Other - Prefix:MISS
Other - First Name:CATHARINE
Other - Middle Name:JOHANNA
Other - Last Name:MADJID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0569
Mailing Address - Country:US
Mailing Address - Phone:425-212-4200
Mailing Address - Fax:425-212-4201
Practice Address - Street 1:811 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4543
Practice Address - Country:US
Practice Address - Phone:425-212-4200
Practice Address - Fax:425-212-4201
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health