Provider Demographics
NPI:1427180298
Name:WRIGHT, CHUCK (MA)
Entity Type:Individual
Prefix:MR
First Name:CHUCK
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16030 BOTHELL EVERETT HWY
Mailing Address - Street 2:STE 200
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1741
Mailing Address - Country:US
Mailing Address - Phone:425-745-4910
Mailing Address - Fax:425-338-5709
Practice Address - Street 1:16030 BOTHELL EVERETT HWY
Practice Address - Street 2:STE 200
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1741
Practice Address - Country:US
Practice Address - Phone:425-745-4910
Practice Address - Fax:425-338-5709
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005156101YM0800X
WALF00001130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5492WROtherREGENCE