Healthcare Provider Details

I. General information

NPI: 1285746206
Provider Name (Legal Business Name): KATRINA N HAYS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 S CUSHMAN AVE
TACOMA WA
98405-3631
US

IV. Provider business mailing address

13011 MERIDIAN E APARTMENT W212
PUYALLUP WA
98373-5638
US

V. Phone/Fax

Practice location:
  • Phone: 253-396-1634
  • Fax: 253-396-1663
Mailing address:
  • Phone: 253-232-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRC00051467
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: