Healthcare Provider Details

I. General information

NPI: 1689338246
Provider Name (Legal Business Name): KAZUYO ASADA PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14040 NE 8TH ST STE 224
BELLEVUE WA
98007-4138
US

IV. Provider business mailing address

231 SE BARRINGTON DR STE 202
OAK HARBOR WA
98277-3200
US

V. Phone/Fax

Practice location:
  • Phone: 206-462-8415
  • Fax:
Mailing address:
  • Phone: 206-462-8415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAZUYO ASADA
Title or Position: CEO/ CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 206-462-8415