Provider Demographics
NPI:1669822268
Name:OLVERA, KATIE PLEWA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:PLEWA
Last Name:OLVERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:OLVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1140 10TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7053
Mailing Address - Country:US
Mailing Address - Phone:360-305-3909
Mailing Address - Fax:
Practice Address - Street 1:1140 10TH ST
Practice Address - Street 2:#214
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-305-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60352628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical