Provider Demographics
NPI:1447651187
Name:CHARTERS, KATHERINE MARY
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARY
Last Name:CHARTERS
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 1:21907 64TH AVE W
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2200
Mailing Address - Country:US
Mailing Address - Phone:206-362-7282
Mailing Address - Fax:206-362-7152
Practice Address - Street 1:21907 64TH AVE W
Practice Address - Street 2:SUITE 240
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2200
Practice Address - Country:US
Practice Address - Phone:206-362-7282
Practice Address - Fax:206-362-7152
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health