MEDICARE: CATHERINE MARGARET HEATH

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP00002522	WA
2	101YM0800X	Mental Health Counselor	LH 60160392	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8923370	OTHER	WA	CRIME VICTIMS COMPENSATIO

General Provider Information

NPI Number	:	1740358407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MARGARET HEATH

Provider Business Mailing Address
First Line	:	3272 CALIFORNIA AVE SW STE 105
Second Line	:	P.O. BOX 47342 SEATTLE, WA. 98146
City	:	SEATTLE
State	:	WA
Zip	:	98116
Country	:	US
Telephone Number	:	206-650-2178
Fax Number	:	206-762-4838

Provider Business Practice Location Address
First Line	:	3272 CALIFORNIA AVE SW STE 105
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3375
Country	:	US
Telephone Number	:	206-650-2178
Fax Number	:	206-762-4838

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	11/03/2023

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