Organization
KATIE'S WAY TACOMA, LLC
Active
Other names
KATIES WAY
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY RAE JOHNSON (CREDENTIALING DIRECTOR)
(785) 320-6616
Entity
Organization
Contact information
Practice address
6704 TACOMA MALL BLVD STE 111, TACOMA, WA 98409-9001
(253) 260-3460
(253) 397-3443
Mailing address
6704 TACOMA MALL BLVD STE 111, TACOMA, WA 98409-9001
(253) 260-3460
(253) 397-3443
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
202D00000X
Integrative Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
2084P0015X
Psychosomatic Medicine Physician
—
—
Other
Enumeration date
01/15/2024
Last updated
11/21/2024
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