Healthcare Provider Details

I. General information

NPI: 1073123733
Provider Name (Legal Business Name): NAMKUNG COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 NE 125TH ST STE 116
SEATTLE WA
98125-4374
US

IV. Provider business mailing address

PO BOX 30715
SEATTLE WA
98113-0715
US

V. Phone/Fax

Practice location:
  • Phone: 206-717-3838
  • Fax: 206-326-1040
Mailing address:
  • Phone: 206-354-8629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. YOUNGNAN NANCY NAMKUNG
Title or Position: MENTAL HEALTH THERAPIST
Credential: LICSW
Phone: 206-717-3838