Healthcare Provider Details

I. General information

NPI: 1023319084
Provider Name (Legal Business Name): CAITLIN C SAUNDERS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22525 SE 64TH PL STE 200
ISSAQUAH WA
98027-5307
US

IV. Provider business mailing address

22717 135TH AVE SE
KENT WA
98042-3730
US

V. Phone/Fax

Practice location:
  • Phone: 206-485-3559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60772409
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: