Provider Demographics
NPI:1649641333
Name:PERUCHINI, JASON (LMFT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:PERUCHINI
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2255
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-2255
Mailing Address - Country:US
Mailing Address - Phone:425-298-6471
Mailing Address - Fax:
Practice Address - Street 1:11900 NE 1ST ST STE 300
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3049
Practice Address - Country:US
Practice Address - Phone:425-298-6471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist