Healthcare Provider Details

I. General information

NPI: 1982978649
Provider Name (Legal Business Name): SOKUNTHEA OK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3639 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-6847
US

IV. Provider business mailing address

3639 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-6847
US

V. Phone/Fax

Practice location:
  • Phone: 206-695-7600
  • Fax: 206-805-8936
Mailing address:
  • Phone: 206-695-7600
  • Fax: 206-805-8936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: