Provider Demographics
NPI:1295824993
Name:JUNG, KAREN V (MA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:V
Last Name:JUNG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:JUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:14220 95TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-5152
Mailing Address - Country:US
Mailing Address - Phone:425-487-3355
Mailing Address - Fax:
Practice Address - Street 1:14220 95TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5152
Practice Address - Country:US
Practice Address - Phone:425-487-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALA00003941101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA211262OtherTRI-CARE
WAJU4229OtherREGENCE