Healthcare Provider Details

I. General information

NPI: 1285571992
Provider Name (Legal Business Name): KATIE GRUVER MFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 HOLMAN RD NW STE 4
SEATTLE WA
98117-3481
US

IV. Provider business mailing address

8619 JONES AVE NW
SEATTLE WA
98117-3748
US

V. Phone/Fax

Practice location:
  • Phone: 206-962-1735
  • Fax:
Mailing address:
  • Phone: 206-962-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70049030
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: