Healthcare Provider Details

I. General information

NPI: 1992508014
Provider Name (Legal Business Name): KATHERINE BRIANNE PAUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 NE MAPLE ST
PULLMAN WA
99163-4120
US

IV. Provider business mailing address

557 SE SHOEMAKER PL
PULLMAN WA
99163-5528
US

V. Phone/Fax

Practice location:
  • Phone: 509-334-1133
  • Fax:
Mailing address:
  • Phone: 208-651-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: