MEDICARE: KATY A PERCINI MA

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	LF60778606	WA

General Provider Information

NPI Number	:	1770983215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATY A PERCINI MA

Provider Business Mailing Address
First Line	:	1928 43RD AVE E APT 5
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-6217
Country	:	US
Telephone Number	:	360-581-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 43RD AVE E APT 5
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-6217
Country	:	US
Telephone Number	:	360-581-3660
Fax Number	:

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

Provider Enumeration Date	:	09/03/2014
Last Update Date	:	11/30/2018

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Directions to “ KATY A PERCINI MA” Practice Location

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