Healthcare Provider Details
I. General information
NPI: 1346113446
Provider Name (Legal Business Name): KRISTEN O'LOUGHLIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/25/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
325 9TH AVE
SEATTLE WA
98104-2420
US
IV. Provider business mailing address
PO BOX 50095
SEATTLE WA
98145-5095
US
V. Phone/Fax
- Phone: 206-520-5000
- Fax:
- Phone: 206-520-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY61617309 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TR0400X |
| Taxonomy | Rehabilitation Psychologist |
| License Number | PY61617309 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: