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General NPI Number Information
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NPI Number | 1801001839
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Entity Type | Individual
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Provider Name | KATLAINA RAYNE M.A,
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Gender | Female
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Dates
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Enumeration Date | 05/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 303 NE 7TH ST
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City | COUPEVILLE
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State | WA
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Zip | 98239-3571
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Country | US
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Telephone | 360-678-0804
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Fax | 360-678-4887
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Provider Business Mailing Address
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Address Line | 303 NE 7TH ST
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City | COUPEVILLE
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State | WA
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Zip | 98239-3571
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Country | US
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Telephone | 360-678-0804
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Fax | 360-678-4887
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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 | LH00006593
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License Number State | WA
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