| |
6505 216th St Sw Ste 100 Mountlake Ter WA 98043-2089 | |
(470) 594-2570 | |
(470) 275-0775 |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 6505 216th St Sw Ste 100, Mountlake Ter, Washington |
Authorized Official Name and Position | Chika O Okem Akwiwu (NURSE PRACTITONER) |
Authorized Official Contact | 4045473893 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3995 Bonnett Creek Ln Hoschton GA 30548-6205 Ph: (470) 594-2570 | 6505 216th St Sw Ste 100 Mountlake Ter WA 98043-2089 Ph: (470) 594-2570 |
NPI Number | 1962020859 |
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Provider Enumeration Date | 07/08/2020 |
Last Update Date | 09/28/2020 |
Certification Date | 09/28/2020 |
Medicare PECOS PAC ID | 1557789047 |
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Medicare Enrollment ID | O20200915003065 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962020859 | NPI | - | NPPES |
Provider Name | Chika Okem Akwiwu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750829123 PECOS PAC ID: 6002183712 Enrollment ID: I20200521002309 |