Provider Demographics
NPI:1730251885
Name:IGNACIO, KATHRANE M (MS, LMHC)
Entity type:Individual
Prefix:
First Name:KATHRANE
Middle Name:M
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W 7TH AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2821
Mailing Address - Country:US
Mailing Address - Phone:509-869-9662
Mailing Address - Fax:509-484-6191
Practice Address - Street 1:707 W 7TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2821
Practice Address - Country:US
Practice Address - Phone:509-684-4597
Practice Address - Fax:509-484-6191
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00051323101YM0800X
WALH00011379101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2125024Medicaid