Basic Information
| Provider Information | |||||||||
| NPI: | 1265676225 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCNICHOLS | ||||||||
| FirstName: | KATHARINE | ||||||||
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| Credential: | LSWAIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 SPRUCE ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065483012 | ||||||||
| FaxNumber: | 2064618382 | ||||||||
| Practice Location | |||||||||
| Address1: | 5950 DELRIDGE WAY SW | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981061446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2069381360 | ||||||||
| FaxNumber: | 2069356056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2009 | ||||||||
| LastUpdateDate: | 10/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.