Healthcare Provider Details

I. General information

NPI: 1043747330
Provider Name (Legal Business Name): KATHERINE ANNE COOK MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHY A COOK MSW, LICSW

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 COLBY AVE
EVERETT WA
98201-2914
US

IV. Provider business mailing address

2416 COLBY AVE
EVERETT WA
98201-2914
US

V. Phone/Fax

Practice location:
  • Phone: 425-551-1140
  • Fax:
Mailing address:
  • Phone: 425-551-1140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWI.LW.61136203
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number61136203
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: