Provider Demographics
NPI:1750636155
Name:KUCH, DONALD ALAN (MA)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ALAN
Last Name:KUCH
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 1:1800 112TH AVE NE
Mailing Address - Street 2:STE 150W
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2993
Mailing Address - Country:US
Mailing Address - Phone:425-646-7279
Mailing Address - Fax:425-671-6496
Practice Address - Street 1:1800 112TH AVE NE
Practice Address - Street 2:STE 150W
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2993
Practice Address - Country:US
Practice Address - Phone:425-646-7279
Practice Address - Fax:425-671-6496
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60153312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health