MEDICARE: KATHY DRESCHER LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF00001223	WA

General Provider Information

NPI Number	:	1063577591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY DRESCHER LMFT

Provider Business Mailing Address
First Line	:	PO BOX 571
Second Line	:
City	:	OLALLA
State	:	WA
Zip	:	98359-0571
Country	:	US
Telephone Number	:	253-857-4366
Fax Number	:	253-857-2415

Provider Business Practice Location Address
First Line	:	13603 FAGERUD RD SE
Second Line	:
City	:	OLALLA
State	:	WA
Zip	:	98359-9523
Country	:	US
Telephone Number	:	253-857-4366
Fax Number	:	253-857-2415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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