Kelly, Katherine Jane

Kelly, Katherine Jane is an individual health care provider with primary practice located at 9040 Jackson Avenue , Tacoma WA 98531. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kelly, Katherine Jane can be contacted via phone (425) 757-2920.

Contact Information

Primary practice address
9040 Jackson Avenue Tacoma WA 98531
Phone: (425) 757-2920
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X PY60563485 Washington
Behavioral Health & Social Service Providers / Counseling 103TC1900X 102699 North Carolina
Behavioral Health & Social Service Providers / Health Service 103TH0100X 1070 South Carolina
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY60563485 Washington

Profile Details

NPI number 1841483286
LBN Legal business name Kelly, Katherine Jane
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2007
Last updated Mar 13th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841483286 NPPES
South Carolina MEDICAID 1070

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