Provider Demographics
NPI:1366893448
Name:CANIDA, KAREN D (CDP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:D
Last Name:CANIDA
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 121ST ST SE APT V101
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7903
Mailing Address - Country:US
Mailing Address - Phone:425-501-7177
Mailing Address - Fax:
Practice Address - Street 1:3810 196TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5746
Practice Address - Country:US
Practice Address - Phone:425-248-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003268101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)