Provider Demographics
NPI:1184348187
Name:KALTEICH, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KALTEICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SOUTH LN
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-1353
Mailing Address - Country:US
Mailing Address - Phone:503-545-5478
Mailing Address - Fax:
Practice Address - Street 1:150 NICKERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1634
Practice Address - Country:US
Practice Address - Phone:206-929-5992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61323339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health