Provider Demographics
NPI:1255425104
Name:MERCER, KATRINA (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:MA, LMHC
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 1530
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-1530
Mailing Address - Country:US
Mailing Address - Phone:425-844-0412
Mailing Address - Fax:
Practice Address - Street 1:16701 NE 80TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3937
Practice Address - Country:US
Practice Address - Phone:425-844-0412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health