Organization
KATIE'S WAY TACOMA, LLC
Active
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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