Healthcare Provider Details

I. General information

NPI: 1093640203
Provider Name (Legal Business Name): KATHERINE BOUGLAI MACDONALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4806 21ST AVENUE CT NW
GIG HARBOR WA
98335-2425
US

IV. Provider business mailing address

4806 21ST AVENUE CT NW
GIG HARBOR WA
98335-2425
US

V. Phone/Fax

Practice location:
  • Phone: 206-795-8592
  • Fax:
Mailing address:
  • Phone: 206-795-8592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCAAR.CG.70134841
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: