Provider Demographics
NPI:1104368919
Name:TONKOVICH, DEBBIE COHN
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:COHN
Last Name:TONKOVICH
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 1:5028 HAROLD PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2809
Mailing Address - Country:US
Mailing Address - Phone:206-295-4716
Mailing Address - Fax:
Practice Address - Street 1:5028 HAROLD PL NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2809
Practice Address - Country:US
Practice Address - Phone:206-295-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60629129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health