Provider Demographics
NPI:1902380553
Name:KRAMER, KASEY MICHAEL (MSED, MHP)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:MICHAEL
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MSED, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 S SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2741
Mailing Address - Country:US
Mailing Address - Phone:509-951-6645
Mailing Address - Fax:
Practice Address - Street 1:720 W BOONE AVE STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2560
Practice Address - Country:US
Practice Address - Phone:509-328-3802
Practice Address - Fax:509-328-3871
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health