Powell, Kristine Rae Vandermark

Powell, Kristine Rae Vandermark is an individual health care provider with primary practice located at 1800 Cooper Point Rd Sw Bldg 17, Olympia WA 98502-1178. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Powell, Kristine Rae Vandermark can be contacted via phone (360) 352-4602.

Contact Information

Primary practice address
1800 Cooper Point Rd Sw Bldg 17 Olympia WA 98502-1178
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PY00002568 Washington

Profile Details

NPI number 1477601789
LBN Legal business name Powell, Kristine Rae Vandermark
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Jul 8th, 2007 - about 17 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 1477601789 NPPES
Washington Other PY00002568 STATE LICENSE
Washington Other 0157189 STATE LICENSE

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