Provider Demographics
NPI:1952654204
Name:KATE LUND PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:KATE LUND PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-231-1602
Mailing Address - Street 1:PO BOX 162
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-0162
Mailing Address - Country:US
Mailing Address - Phone:425-231-1602
Mailing Address - Fax:
Practice Address - Street 1:300 ADMIRAL WAY
Practice Address - Street 2:SUITE 207
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-7230
Practice Address - Country:US
Practice Address - Phone:425-231-1602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60232876251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health