Provider Demographics
NPI:1386310647
Name:BETAH, HONORINE NCHUO (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HONORINE
Middle Name:NCHUO
Last Name:BETAH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:HONORINE
Other - Middle Name:NCHUO
Other - Last Name:CHUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18383 PRESTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5487
Mailing Address - Country:US
Mailing Address - Phone:214-983-9811
Mailing Address - Fax:
Practice Address - Street 1:4803 FREMONT AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6527
Practice Address - Country:US
Practice Address - Phone:855-444-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049139363LP0808X
WAAP61454755363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health