Individual
KIERSTIN T TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60059957
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912020827
—
WA
01
—
P01643639
RR PTAN WVH
WA
Enumeration date
04/06/2007
Last updated
05/02/2024
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