Healthcare Provider Details

I. General information

NPI: 1891591087
Provider Name (Legal Business Name): DUYGU KUZU-BASDOGAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5635 129TH AVE SE
BELLEVUE WA
98006-3975
US

IV. Provider business mailing address

5635 129TH AVE SE
BELLEVUE WA
98006-3975
US

V. Phone/Fax

Practice location:
  • Phone: 804-998-0400
  • Fax:
Mailing address:
  • Phone: 804-998-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61615537
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: