Provider Demographics
NPI:1003930389
Name:GORMAN, KAREN LOUISE (MA PSYCHOLOGY)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LOUISE
Last Name:GORMAN
Suffix:
Gender:F
Credentials:MA PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-0003
Mailing Address - Country:US
Mailing Address - Phone:360-692-7001
Mailing Address - Fax:360-692-6458
Practice Address - Street 1:9395 LINDER WAY NW STE 202
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9149
Practice Address - Country:US
Practice Address - Phone:360-692-7001
Practice Address - Fax:360-692-6458
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003477101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health