Provider Demographics
NPI:1932565017
Name:KATIJEAN THORPE, MSW, P.S.
Entity Type:Organization
Organization Name:KATIJEAN THORPE, MSW, P.S.
Other - Org Name:KATE THORPE, LICSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATIJEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:360-565-6028
Mailing Address - Street 1:PO BOX 274
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-0045
Mailing Address - Country:US
Mailing Address - Phone:360-565-6028
Mailing Address - Fax:360-323-6403
Practice Address - Street 1:9732 OLD OLYMPIC HWY
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3150
Practice Address - Country:US
Practice Address - Phone:360-565-6028
Practice Address - Fax:360-323-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 600639101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8914039OtherPTAN