Healthcare Provider Details

I. General information

NPI: 1568228203
Provider Name (Legal Business Name): MS. KARA MARAN HARRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N 85TH ST APT 301
SEATTLE WA
98103-3836
US

IV. Provider business mailing address

730 N 85TH ST APT 301
SEATTLE WA
98103-3836
US

V. Phone/Fax

Practice location:
  • Phone: 912-381-6052
  • Fax:
Mailing address:
  • Phone: 912-381-6052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.61534669
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: