Provider Demographics
NPI:1245538834
Name:RICHARD, KAREN ANDREA
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANDREA
Last Name:RICHARD
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:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-0212
Mailing Address - Country:US
Mailing Address - Phone:360-373-3776
Mailing Address - Fax:360-373-2096
Practice Address - Street 1:400 WARREN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1487
Practice Address - Country:US
Practice Address - Phone:360-478-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health