Provider Demographics
NPI:1740980093
Name:DUCHARME, DUSTIN (PHD)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 130TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3333
Mailing Address - Country:US
Mailing Address - Phone:603-361-6726
Mailing Address - Fax:
Practice Address - Street 1:615 130TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3333
Practice Address - Country:US
Practice Address - Phone:603-361-6726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty