Healthcare Provider Details

I. General information

NPI: 1063214120
Provider Name (Legal Business Name): CATARINA SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MAIN ST STE 101
BATTLE GROUND WA
98604-4483
US

IV. Provider business mailing address

2411 NW 15TH ST
BATTLE GROUND WA
98604-4463
US

V. Phone/Fax

Practice location:
  • Phone: 360-619-2226
  • Fax:
Mailing address:
  • Phone: 360-936-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberCAAC.CQ.61680481
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: