Provider Demographics
NPI:1962655399
Name:KUNCHANDY, ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:KUNCHANDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17523 19TH CT NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5262
Mailing Address - Country:US
Mailing Address - Phone:206-999-4587
Mailing Address - Fax:206-770-7303
Practice Address - Street 1:17544 MIDVALE AVE N STE 207
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-4921
Practice Address - Country:US
Practice Address - Phone:206-999-4587
Practice Address - Fax:206-770-7303
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation