Individual
KATHRYN AMANDA LIDGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
2100 24TH AVE S STE 260, SEATTLE, WA 98144-4644
(206) 715-6051
Mailing address
2100 24TH AVE S STE 260, SEATTLE, WA 98144-4644
(206) 715-6051
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC60970292
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/10/2017
Last updated
08/05/2019
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