Healthcare Provider Details

I. General information

NPI: 1346644481
Provider Name (Legal Business Name): MARY KATE STANTON-NURSE LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MARY KATE SIMPSON-STANTON

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 NE RAVENNA BLVD
SEATTLE WA
98115-6460
US

IV. Provider business mailing address

13543 BURKE AVE N
SEATTLE WA
98133-7712
US

V. Phone/Fax

Practice location:
  • Phone: 206-527-2266
  • Fax:
Mailing address:
  • Phone: 206-412-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG60682412
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: