Provider Demographics
NPI:1467812313
Name:DACUAG, AMY MICHELE (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MICHELE
Last Name:DACUAG
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6319 BROOKLYN AVE NE APT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6731
Mailing Address - Country:US
Mailing Address - Phone:425-802-1686
Mailing Address - Fax:
Practice Address - Street 1:6319 BROOKLYN AVE NE APT B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6731
Practice Address - Country:US
Practice Address - Phone:425-802-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist