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General NPI Number Information
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NPI Number | 1134901994
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Entity Type | Individual
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Provider Name | KRISTINA ELIZABETH BETZ LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3560 BRIDGEPORT WAY W
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4446
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Country | US
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Telephone | 253-460-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 151 E PARK LOOP
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City | SHELTON
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State | WA
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Zip | 98584-9034
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Country | US
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Telephone | 206-250-4801
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MG61420925
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License Number State | WA
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