Provider Demographics
NPI:1144992231
Name:BROTTEN, KATIE (MSW LSWAIC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:BROTTEN
Suffix:
Gender:F
Credentials:MSW LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11416 SLATER AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4600
Mailing Address - Country:US
Mailing Address - Phone:206-853-7364
Mailing Address - Fax:
Practice Address - Street 1:11416 SLATER AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4600
Practice Address - Country:US
Practice Address - Phone:206-853-7364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61207927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health