Provider Demographics
NPI:1558767855
Name:DADERKO, KATHARINE
Entity Type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:
Last Name:DADERKO
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 1:10732 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6926
Mailing Address - Country:US
Mailing Address - Phone:206-395-6405
Mailing Address - Fax:
Practice Address - Street 1:18500 156TH AVE NE
Practice Address - Street 2:SUITE 202
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4459
Practice Address - Country:US
Practice Address - Phone:206-395-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist