Basic Information
Provider Information
NPI: 1003151986
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUCKEL
FirstName: ASHLEE
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential:  
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OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Practice Location
Address1: 14216 NE 21ST ST
Address2: SOUND MENTAL HEALTH
City: BELLEVUE
State: WA
PostalCode: 980073720
CountryCode: US
TelephoneNumber: 2063022362
FaxNumber: 4256534900
Other Information
ProviderEnumerationDate: 12/04/2012
LastUpdateDate: 12/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XMC60579598WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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