Healthcare Provider Details

I. General information

NPI: 1487081774
Provider Name (Legal Business Name): KAREN MARIE BARNES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE MS CAC
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4909 25TH AVE NE
SEATTLE WA
98105-4107
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-7997
  • Fax: 206-987-8081
Mailing address:
  • Phone: 206-987-7975
  • Fax: 206-987-8081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number60345496
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: