Provider Demographics
NPI:1487897286
Name:TUCKER, CHARLOTTE (RC)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:AKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 SPRUCE ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2474
Mailing Address - Country:US
Mailing Address - Phone:206-461-6935
Mailing Address - Fax:206-461-8382
Practice Address - Street 1:1629 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6701
Practice Address - Country:US
Practice Address - Phone:206-633-3350
Practice Address - Fax:206-633-3113
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00021201101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor