MEDICARE: CATHARINE CARSON LMFTA

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	106H00000X	Marriage & Family Therapist	MFTA.MG.61126431	WA

General Provider Information

NPI Number	:	1336790872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINE CARSON LMFTA

Provider Business Mailing Address
First Line	:	3417 EVANSTON AVE N STE 318
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8967
Country	:	US
Telephone Number	:	206-375-7045
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 EVANSTON AVE N STE 318
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8967
Country	:	US
Telephone Number	:	206-375-7045
Fax Number	:

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

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	06/04/2021

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