Provider Demographics
NPI:1740790302
Name:KAUFMAN, MARIE E (CDPT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:E
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3416
Mailing Address - Country:US
Mailing Address - Phone:425-322-0876
Mailing Address - Fax:
Practice Address - Street 1:2732 GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3416
Practice Address - Country:US
Practice Address - Phone:425-322-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)