Provider Demographics
NPI:1548590946
Name:LINDAUER, KATRINA (MA)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:LINDAUER
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 1:409 CUSTER WAY SE STE D
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3300
Mailing Address - Country:US
Mailing Address - Phone:360-704-7590
Mailing Address - Fax:
Practice Address - Street 1:409 CUSTER WAY SE STE D
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-3300
Practice Address - Country:US
Practice Address - Phone:360-704-7590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60129780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health