Basic Information
Provider Information
NPI: 1952830101
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DHUNGYEL
FirstName: AMBIKA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3639 MLK JR WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981446847
CountryCode: US
TelephoneNumber: 2066957600
FaxNumber:  
Practice Location
Address1: 3639 MLK JR WAY S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981446847
CountryCode: US
TelephoneNumber: 2066957600
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/09/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XCG60650617WAY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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