Provider Demographics
NPI:1184399347
Name:KNIERIEM, KATHLEEN SUE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:SUE
Last Name:KNIERIEM
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 BERRY LN E
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-2114
Mailing Address - Country:US
Mailing Address - Phone:253-307-8683
Mailing Address - Fax:
Practice Address - Street 1:6401 ROSEMOUNT DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-6628
Practice Address - Country:US
Practice Address - Phone:206-730-2162
Practice Address - Fax:253-270-1429
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical