Individual
KATIE THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
810 E ANGIE AVE, MEDICAL LAKE, WA 99022-5004
(586) 321-7265
Mailing address
810 E ANGIE AVE, MEDICAL LAKE, WA 99022
(586) 321-7265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC60581212
WA
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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