Provider Demographics
NPI:1144720475
Name:KUKAHIKO, DEBORAH PAXTON (LMHCA)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:PAXTON
Last Name:KUKAHIKO
Suffix:
Gender:F
Credentials:LMHCA
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 1498
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-1498
Mailing Address - Country:US
Mailing Address - Phone:425-320-6381
Mailing Address - Fax:
Practice Address - Street 1:1720 GROVE ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4328
Practice Address - Country:US
Practice Address - Phone:425-320-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60691336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health