1346797172 NPI number — MRS. KAYA WYNN O'CONNOR MSW, LICSW

Table of content: MRS. KAYA WYNN O'CONNOR MSW, LICSW (NPI 1346797172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346797172 NPI number — MRS. KAYA WYNN O'CONNOR MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'CONNOR
Provider First Name:
KAYA
Provider Middle Name:
WYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WYNN
Provider Other First Name:
KAYA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW, LICSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1346797172
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8015 SE 28TH STREET
Provider Second Line Business Mailing Address:
SUITE 309
Provider Business Mailing Address City Name:
MERCER ISLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-651-4729
Provider Business Mailing Address Fax Number:
206-302-2210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8015 SE 28TH STREET
Provider Second Line Business Practice Location Address:
SUITE 309
Provider Business Practice Location Address City Name:
MERCER ISLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-444-3600
Provider Business Practice Location Address Fax Number:
206-444-3610
Provider Enumeration Date:
09/09/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LW61374691 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)