Provider Demographics
NPI:1053875906
Name:KOVIAK, RAQUEL
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:
Last Name:KOVIAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 MUNRAS AVE STE F
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3121
Mailing Address - Country:US
Mailing Address - Phone:831-233-0601
Mailing Address - Fax:
Practice Address - Street 1:450 ALASKAN WAY S STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:323-205-7088
Practice Address - Fax:323-205-7088
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61551601101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health