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General NPI Number Information
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NPI Number | 1528472537
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Entity Type | Organization
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Legal Business Name | DR.KATIE EASTMAN, INC.
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 1909 SKYLINE WAY SUITE 103
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City | ANACORTES
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State | WA
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Zip | 98221-2992
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Country | US
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Telephone | 360-873-8662
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Fax | 207-433-1133
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Provider Business Mailing Address
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Address Line | 1909 SKYLINE WAY SUITE 103
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City | ANACORTES
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State | WA
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Zip | 98221-2992
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Country | US
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Telephone | 360-873-8662
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Fax | 207-433-1133
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTINE KATE EASTMAN
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Credential | PSY.D, LICSW
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Telephone | 360-873-8662
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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 | LW60234810
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License Number State | WA
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