Provider Demographics
NPI:1568228203
Name:HARRISON, KARA MARAN
Entity Type:Individual
Prefix:MS
First Name:KARA
Middle Name:MARAN
Last Name:HARRISON
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 1:730 N 85TH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3836
Mailing Address - Country:US
Mailing Address - Phone:912-381-6052
Mailing Address - Fax:
Practice Address - Street 1:730 N 85TH ST APT 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3836
Practice Address - Country:US
Practice Address - Phone:912-381-6052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101200000X
WAMFTA.MG.61534669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist