Provider Demographics
NPI:1699030668
Name:MCMONAGLE, KIERAN SAWYER
Entity Type:Individual
Prefix:MS
First Name:KIERAN
Middle Name:SAWYER
Last Name:MCMONAGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:MARYVIRGINIA
Other - Last Name:MCMONAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:8648 BEACON AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4526
Mailing Address - Country:US
Mailing Address - Phone:206-877-3330
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8626
Practice Address - Country:US
Practice Address - Phone:206-877-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA390200000X
WALF60608556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program