Provider Demographics
NPI:1336202464
Name:NELSON, KATHARINE ELLEN (MS,MCC,LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:ELLEN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS,MCC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 NE 55TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2262
Mailing Address - Country:US
Mailing Address - Phone:206-525-6939
Mailing Address - Fax:206-524-7653
Practice Address - Street 1:4026 NE 55TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2262
Practice Address - Country:US
Practice Address - Phone:206-525-6939
Practice Address - Fax:206-524-7653
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004696101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health