Provider Demographics
NPI:1043890999
Name:SPLAINE-DUCHSHERER, KATIE-MAUREEN
Entity type:Individual
Prefix:
First Name:KATIE-MAUREEN
Middle Name:
Last Name:SPLAINE-DUCHSHERER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6634 112TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-6424
Mailing Address - Country:US
Mailing Address - Phone:425-943-1027
Mailing Address - Fax:
Practice Address - Street 1:12507 NE BEL RED RD STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2500
Practice Address - Country:US
Practice Address - Phone:425-371-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61308084101Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor