Provider Demographics
NPI:1144688565
Name:KAMALA PSYCHOLOGY AND YOGA LLC
Entity type:Organization
Organization Name:KAMALA PSYCHOLOGY AND YOGA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCH
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-403-6463
Mailing Address - Street 1:361 COBALT BAY LOOP APT 104
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-1631
Mailing Address - Country:US
Mailing Address - Phone:425-403-6463
Mailing Address - Fax:
Practice Address - Street 1:607 MARKET ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5404
Practice Address - Country:US
Practice Address - Phone:425-403-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-30
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY6041422103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty