Healthcare Provider Details

I. General information

NPI: 1144386319
Provider Name (Legal Business Name): MON-LIN KUO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 E MADISON ST SUITE 205
SEATTLE WA
98112-4752
US

IV. Provider business mailing address

2719 E MADISON ST SUITE 205
SEATTLE WA
98112-4752
US

V. Phone/Fax

Practice location:
  • Phone: 206-789-0166
  • Fax:
Mailing address:
  • Phone: 206-789-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF00002528
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: