Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY60312491 | WA |
Y | 103TC0700X | Clinical Psychologist | PY60312491 | WA |
NPI | 1003251406 |
---|---|
Provider Name | Katherine Evans Stanfill |
First Address | Seattle, WA 98116-4553 |
Second Address | Seattle, WA 98109-6212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 19/06/2019 |