Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OT61017518 | WA |
NPI | 1184385460 |
---|---|
Provider Name | Laura Catherine Krebser |
First Address | Olympia, WA 98502-4783 |
Second Address | Lakewood, WA 98498-7212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2022 |
Last Update Date | 07/01/2022 |