Provider Demographics
NPI:1740591486
Name:MEYER, KARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6422
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-6422
Mailing Address - Country:US
Mailing Address - Phone:360-402-6117
Mailing Address - Fax:360-512-3656
Practice Address - Street 1:825 LEGION WAY SE
Practice Address - Street 2:STE D
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1586
Practice Address - Country:US
Practice Address - Phone:360-402-6117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY61046646103TB0200X, 103TC2200X
WAPY60146646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical