Healthcare Provider Details

I. General information

NPI: 1700447620
Provider Name (Legal Business Name): MONICA CAGAYAT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 07/22/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 NE 203RD ST STE 200
KENMORE WA
98028-1945
US

IV. Provider business mailing address

6021 NE 203RD ST STE 200
KENMORE WA
98028-1945
US

V. Phone/Fax

Practice location:
  • Phone: 603-969-3237
  • Fax:
Mailing address:
  • Phone: 603-969-3237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60460799
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: