=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629845318
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHERINE WARNER AAC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2023
-----------------------------------------------------
Last Update Date | 12/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2924 FALK RD
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98661-5604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-690-3069
-----------------------------------------------------
Fax | 360-726-5961
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4903 PLOMONDON ST APT 14
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98661-6162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-980-1316
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | CG61101263
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------