Powell, Kristine Rae Vandermark
Powell, Kristine Rae Vandermark is an individual health care provider with primary practice located at 1800 Cooper Point Rd Sw Bldg 17, Olympia WA 98502-1178. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Powell, Kristine Rae Vandermark can be contacted via phone (360) 352-4602.Contact Information
Primary practice address
1800 Cooper Point Rd Sw Bldg 17
Olympia WA 98502-1178
Phone: (360) 352-4602
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PY00002568 | Washington |
Profile Details
| NPI number | 1477601789 |
|---|---|
| LBN Legal business name | Powell, Kristine Rae Vandermark |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477601789 | NPPES |
| Washington | Other | PY00002568 | STATE LICENSE |
| Washington | Other | 0157189 | STATE LICENSE |
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