Provider Demographics
NPI:1457478968
Name:KOENIG, GRETCHEN (LMFT)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:KOENIG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 NW LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8303
Mailing Address - Country:US
Mailing Address - Phone:720-468-7161
Mailing Address - Fax:
Practice Address - Street 1:98 WADSWORTH BLVD # 1273267
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1550
Practice Address - Country:US
Practice Address - Phone:720-468-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61507765106H00000X
CO0001652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist