Healthcare Provider Details

I. General information

NPI: 1487137634
Provider Name (Legal Business Name): YEVA KHEMCHAN LICSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 08/05/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 ALASKAN WAY S SUITE 200
SEATTLE WA
98104-2785
US

IV. Provider business mailing address

PO BOX 746878
ATLANTA GA
30374-6878
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-7088
  • Fax: 833-419-0181
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL16418
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61517787
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: