Healthcare Provider Details

I. General information

NPI: 1821566076
Provider Name (Legal Business Name): CAITLIN NOELANI MINNIEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WESTLAKE AVE N STE 510
SEATTLE WA
98109-3543
US

IV. Provider business mailing address

1200 WESTLAKE AVE N STE 510
SEATTLE WA
98109-3543
US

V. Phone/Fax

Practice location:
  • Phone: 253-765-8402
  • Fax:
Mailing address:
  • Phone: 253-765-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61336489
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: