Provider Demographics
NPI:1073101705
Name:CHUC, TU KHA
Entity Type:Individual
Prefix:
First Name:TU
Middle Name:KHA
Last Name:CHUC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SE FOSTER RD STE UNIT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-4617
Mailing Address - Country:US
Mailing Address - Phone:503-872-8822
Mailing Address - Fax:503-872-8825
Practice Address - Street 1:9035 SE FOSTER RD STE UNIT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-4617
Practice Address - Country:US
Practice Address - Phone:503-872-8822
Practice Address - Fax:503-872-8825
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health