Provider Demographics
NPI:1962827535
Name:MOSCOVITZ, KARA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:LYNN
Last Name:MOSCOVITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:LYNN
Other - Last Name:KRUSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2841 234TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-6043
Mailing Address - Country:US
Mailing Address - Phone:206-914-6531
Mailing Address - Fax:
Practice Address - Street 1:22525 SE 64TH PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5383
Practice Address - Country:US
Practice Address - Phone:206-914-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60686902103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist