MEDICARE: KATIE WILLOTT MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	MC60517768	WA

General Provider Information

NPI Number	:	1144614371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE WILLOTT MA

Provider Business Mailing Address
First Line	:	336 36TH ST STE 275
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-6580
Country	:	US
Telephone Number	:	206-483-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	2722 EASTLAKE AVE E STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-3143
Country	:	US
Telephone Number	:	206-483-6889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	02/15/2021

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Directions to “ KATIE WILLOTT MA” Practice Location

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