Provider Demographics
NPI:1295838555
Name:ISAROWONG, NUCHA (LCSW, LICSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:NUCHA
Middle Name:
Last Name:ISAROWONG
Suffix:
Gender:M
Credentials:LCSW, LICSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9602 FREMONT AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3139
Mailing Address - Country:US
Mailing Address - Phone:773-620-1628
Mailing Address - Fax:
Practice Address - Street 1:9602 FREMONT AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3139
Practice Address - Country:US
Practice Address - Phone:773-620-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0119911041C0700X
IL19350831041S0200X
WALW613507201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool