Provider Demographics
NPI:1467746412
Name:D'ELENE, KASARA M (MA)
Entity Type:Individual
Prefix:
First Name:KASARA
Middle Name:M
Last Name:D'ELENE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18001 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6895
Mailing Address - Country:US
Mailing Address - Phone:425-415-8410
Mailing Address - Fax:425-415-8432
Practice Address - Street 1:18001 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 109
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6895
Practice Address - Country:US
Practice Address - Phone:425-415-8410
Practice Address - Fax:425-415-8432
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60217274101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor