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General NPI Number Information
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NPI Number | 1396080735
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Entity Type | Individual
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Provider Name | KATIE RENEE WEST MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 325 E PIONEER
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City | PUYALLUP
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State | WA
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Zip | 98372-3265
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Country | US
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Telephone | 253-697-8452
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Fax |
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Provider Business Mailing Address
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Address Line | 11415 SE 229TH ST
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City | KENT
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State | WA
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Zip | 98031-2681
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Country | US
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Telephone | 206-953-6282
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60214955
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License Number State | WA
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