Ayse Didem Koc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61561015 Issued in WA

Practice address

Fountaingate Wellness 1601 10TH St
Marysville, WA 98270

Phone

(360) 653-0374

NPI assigned

Sep 16, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1306673116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 RAINIER AVE S APT 213",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981446042",
            "telephone_number": "425-534-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOUNTAINGATE WELLNESS 1601 10TH ST",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98270",
            "telephone_number": "360-653-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOC",
        "first_name": "AYSE",
        "middle_name": "DIDEM",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61561015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Raeann Klindtworth, M.S., MFT
• Michael R Klindworth, O.D.
• Olivia Margaret Klinkhammer, D.O.
• Knight Vision Northwest PLLC
• Kaeleen Knorr, LMT
• Kimberly Koehler
• Laura Maria Kogson-Pierce, DMD
• Jenny-Lee Kramar, BDS
• Melissa Krieg, PTA
• Kim Martin Kron, OD

• Mental Health Counselor in Marysville, WA
• Providers in Marysville, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.