# BACI COUNSELING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356906853
- **Authorized official:** DR. PHOUKHAM KELLY BOUNKEUA PHD (DIRECTOR/OWNER)
- **Authorized official phone:** (206) 345-2640

## Contact information

- **Practice address:** 3707 SMITHERS AVE S, RENTON, WA 98055-6808
- **Practice address phone:** (206) 356-2640
- **Practice address fax:** (425) 955-9326
- **Mailing address:** 3707 SMITHERS AVE S, RENTON, WA 98055-6808
- **Mailing address phone:** (206) 356-2640
- **Mailing address fax:** (425) 955-9326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2019
- **Last updated:** 05/09/2019