Provider Demographics
NPI:1447942008
Name:UKWU, PASCHAL CHINEDU
Entity type:Individual
Prefix:
First Name:PASCHAL
Middle Name:CHINEDU
Last Name:UKWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 TYEE DR
Mailing Address - Street 2:
Mailing Address - City:POINT ROBERTS
Mailing Address - State:WA
Mailing Address - Zip Code:98281-9627
Mailing Address - Country:US
Mailing Address - Phone:360-815-8026
Mailing Address - Fax:
Practice Address - Street 1:811 MADISON ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4543
Practice Address - Country:US
Practice Address - Phone:425-212-4200
Practice Address - Fax:425-212-4220
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61437871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health