Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 5345 | MN |
N | 103T00000X | Psychologist | 5345 | MN |
N | 102L00000X | Psychologist | PY 60614493 | WA |
N | 103T00000X | Psychologist | PY 60614493 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 5345 | MN |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY 60674493 | WA |
Y | 103TH0100X | Health Service | PY60614493 | WA |
NPI | 1568796993 |
---|---|
Provider Name | Karen Elizabeth Weiss |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2009 |
Last Update Date | 11/12/2020 |