Provider Demographics
NPI:1982152955
Name:OLUKOYA, ADEKUNBI AFUSAT (CDP)
Entity Type:Individual
Prefix:MRS
First Name:ADEKUNBI
Middle Name:AFUSAT
Last Name:OLUKOYA
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:ADEKUNBI
Other - Middle Name:AFUSAT
Other - Last Name:ELEGUSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDP
Mailing Address - Street 1:8625 EVERGREEN WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2647
Mailing Address - Country:US
Mailing Address - Phone:425-320-1499
Mailing Address - Fax:425-265-1671
Practice Address - Street 1:8625 EVERGREEN WAY STE 108
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2647
Practice Address - Country:US
Practice Address - Phone:425-320-1499
Practice Address - Fax:425-265-1671
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60214321101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)