Provider Demographics
NPI:1255785754
Name:VIERRA, KATHLEEN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:VIERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHI
Other - Middle Name:
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 KEENE RD BLDG L
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7752
Mailing Address - Country:US
Mailing Address - Phone:509-420-3442
Mailing Address - Fax:858-521-8173
Practice Address - Street 1:203 MISSION AVE STE 118
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1619
Practice Address - Country:US
Practice Address - Phone:509-420-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst