Provider Demographics
NPI:1912078361
Name:ABUYOG, EDUARDO (LICSW)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:ABUYOG
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:MR
Other - First Name:EDUARDO
Other - Middle Name:
Other - Last Name:ABUYOG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1044 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2506
Mailing Address - Country:US
Mailing Address - Phone:360-353-9494
Mailing Address - Fax:360-353-9440
Practice Address - Street 1:15455 65TH AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2534
Practice Address - Country:US
Practice Address - Phone:206-721-5170
Practice Address - Fax:360-575-1950
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207931041C0700X
WALW000065451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical