Provider Demographics
NPI:1609202936
Name:PAPE, KATHLEEN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:PAPE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 19TH AVE E
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-6315
Mailing Address - Country:US
Mailing Address - Phone:206-328-3050
Mailing Address - Fax:206-324-6517
Practice Address - Street 1:126 19TH AVE E
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-6315
Practice Address - Country:US
Practice Address - Phone:206-328-3050
Practice Address - Fax:206-324-6517
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60689536103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist