Healthcare Provider Details

I. General information

NPI: 1275396038
Provider Name (Legal Business Name): CAITLIN ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 50TH ST CT NW BLDG C
GIG HARBOR WA
98335-8590
US

IV. Provider business mailing address

3208 50TH ST CT NW BLDG C
GIG HARBOR WA
98335-8590
US

V. Phone/Fax

Practice location:
  • Phone: 253-280-9888
  • Fax:
Mailing address:
  • Phone: 253-280-9888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61521042
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2278150
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: