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NPI Code Detail

MEDICARE: DR. JUDATHA TEMPLE KLINE PH.D, LMFT

MEDICARE: DR. JUDATHA TEMPLE KLINE PH.D, 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
1106H00000XMarriage & Family Therapist60681561WA
2106H00000XMarriage & Family TherapistT1048OR

General Provider Information

NPI Number : 1184749442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDATHA TEMPLE KLINE PH.D, LMFT
Provider Business Mailing Address
First Line : 101 E 8TH ST STE 110
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3294
Country : US
Telephone Number : 564-236-6854
Fax Number : 360-938-7016
Provider Business Practice Location Address
First Line : 101 E 8TH ST STE 110
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3294
Country : US
Telephone Number : 564-236-6854
Fax Number : 360-938-7016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 02/04/2026

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