Basic Information
| Provider Information | |||||||||
| NPI: | 1275883241 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRYAN | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | OGILVIE | ||||||||
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| Credential: | J.D., M.A., LMHCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33305 1ST WAY SOUTH - SUITE B-203 | ||||||||
| Address2: | THE CENTER FOR FAMILY AND LIFESPAN DEVELOPMENT | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532355956 | ||||||||
| FaxNumber: | 2532355957 | ||||||||
| Practice Location | |||||||||
| Address1: | 33305 1ST WAY SOUTH - SUITE B-203 | ||||||||
| Address2: | THE CENTER FOR FAMILY AND LIFESPAN DEVELOPMENT | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532355956 | ||||||||
| FaxNumber: | 2532355957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2012 | ||||||||
| LastUpdateDate: | 11/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.