MEDICARE: DR. KATHLEEN KIM LAMPSON REIFF PH.D.

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	103TC0700X	Clinical Psychologist	00001186	WA
2	103TC1900X	Counseling Psychologist	00001186	WA
3	103T00000X	Psychologist	00001186	WA
4	103TB0200X	Cognitive & Behavioral Psychologist	00001186	WA

General Provider Information

NPI Number	:	1306903562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN KIM LAMPSON REIFF PH.D.

Provider Business Mailing Address
First Line	:	9725 SE 36TH ST
Second Line	:	SUITE 301
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-3841
Country	:	US
Telephone Number	:	206-232-8404
Fax Number	:	206-236-2065

Provider Business Practice Location Address
First Line	:	9725 SE 36TH ST
Second Line	:	SUITE 301
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-3841
Country	:	US
Telephone Number	:	206-232-8404
Fax Number	:	206-236-2065

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	09/24/2010

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