Healthcare Provider Details

I. General information

NPI: 1265673420
Provider Name (Legal Business Name): KENDRA ERIN HIGA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KENDRA ERIN GOSSELL

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 DAYTON ST SUITE H
EDMONDS WA
98020-3601
US

IV. Provider business mailing address

555 DAYTON ST SUITE H
EDMONDS WA
98020-3601
US

V. Phone/Fax

Practice location:
  • Phone: 206-300-1102
  • Fax:
Mailing address:
  • Phone: 206-300-1102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF 60486682
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: