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General NPI Number Information
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NPI Number | 1548584303
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Entity Type | Individual
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Provider Name | KATRINA LYNN HIGGINS PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 920 ALDER AVE SUITE 207
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City | SUMNER
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State | WA
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Zip | 98390-1401
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Country | US
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Telephone | 253-230-7919
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Fax | 253-883-3535
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Provider Business Mailing Address
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Address Line | 510 E MAIN STE H
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City | PUYALLUP
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State | WA
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Zip | 98372-5613
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Country | US
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Telephone | 253-230-7919
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Fax | 253-883-3535
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60116078
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License Number State | WA
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