Provider Demographics
NPI:1902973050
Name:STAFFORD, CATHERINE E (BA, MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:E
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:BA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 198TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6762
Mailing Address - Country:US
Mailing Address - Phone:425-275-9071
Mailing Address - Fax:425-275-9045
Practice Address - Street 1:4230 198TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6762
Practice Address - Country:US
Practice Address - Phone:425-275-9071
Practice Address - Fax:425-275-9045
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00006363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7209716OtherAETNA PROVIDER NUMBER