Provider Demographics
NPI:1841346921
Name:ACHESON, KAREN BETH (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:BETH
Last Name:ACHESON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11228 172ND ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-6516
Mailing Address - Country:US
Mailing Address - Phone:253-240-7815
Mailing Address - Fax:253-268-2149
Practice Address - Street 1:11228 172ND ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-6516
Practice Address - Country:US
Practice Address - Phone:253-240-7815
Practice Address - Fax:201-939-3132
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60849445103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME33184000099Medicaid
ME062048296ME02OtherANTHEM