Healthcare Provider Details

I. General information

NPI: 1861305617
Provider Name (Legal Business Name): CAITLIN LARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 R AVE
ANACORTES WA
98221-2276
US

IV. Provider business mailing address

799 CHUCKANUT SHORE RD
BELLINGHAM WA
98229-8925
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-4000
  • Fax:
Mailing address:
  • Phone: 214-931-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.70176676
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: