Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor |
NPI | 1003375718 |
---|---|
Provider Name | Kaitlyn Paige Mach |
First Address | Tacoma, WA 98402-1903 |
Second Address | Tacoma, WA 98402-1903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2019 |
Last Update Date | 04/05/2021 |