MEDICARE: DR. CAROL A. KUSCHE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TP0814X	Psychoanalysis Psychologist	1105	WA

General Provider Information

NPI Number	:	1407074966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL A. KUSCHE PH.D.

Provider Business Mailing Address
First Line	:	927 10TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4511
Country	:	US
Telephone Number	:	206-323-6688
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 10TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4511
Country	:	US
Telephone Number	:	206-323-6688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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