Healthcare Provider Details

I. General information

NPI: 1609512961
Provider Name (Legal Business Name): VIRGINIA KATE VIGNEULLE MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE VIGNEULLE MA, LMHC

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 NW MARKET ST # 716
SEATTLE WA
98107-5264
US

IV. Provider business mailing address

1752 NW MARKET ST # 716
SEATTLE WA
98107-5264
US

V. Phone/Fax

Practice location:
  • Phone: 206-705-3039
  • Fax:
Mailing address:
  • Phone: 206-705-3039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61553516
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: