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General NPI Number Information
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NPI Number | 1467746412
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Entity Type | Individual
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Provider Name | KASARA M D'ELENE M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 18001 BOTHELL EVERETT HWY SUITE 109
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City | BOTHELL
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State | WA
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Zip | 98012-6895
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Country | US
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Telephone | 425-415-8410
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Fax | 425-415-8432
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Provider Business Mailing Address
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Address Line | 18001 BOTHELL EVERETT HWY SUITE 109
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City | BOTHELL
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State | WA
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Zip | 98012-6895
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Country | US
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Telephone | 425-415-8410
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Fax | 425-415-8432
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MC 60217274
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License Number State | WA
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