Healthcare Provider Details

I. General information

NPI: 1003359290
Provider Name (Legal Business Name): KATELYN MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 SW ROCK CREEK DR
STEVENSON WA
98648-4418
US

IV. Provider business mailing address

PO BOX 1492
STEVENSON WA
98648-1492
US

V. Phone/Fax

Practice location:
  • Phone: 509-427-3850
  • Fax: 509-427-0188
Mailing address:
  • Phone: 509-427-3850
  • Fax: 509-427-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70047547
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: