Provider Demographics
NPI:1497426704
Name:OVINGTON, ISHARATH ZAKIA
Entity Type:Individual
Prefix:
First Name:ISHARATH
Middle Name:ZAKIA
Last Name:OVINGTON
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 1:5470 SHILSHOLE AVE NW STE 510
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4040
Mailing Address - Country:US
Mailing Address - Phone:206-619-7628
Mailing Address - Fax:
Practice Address - Street 1:5470 SHILSHOLE AVE NW STE 510
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4040
Practice Address - Country:US
Practice Address - Phone:206-619-7628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-26
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61217380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health