Individual
NIYA KARUKAMATTOM CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 N 115TH ST, SEATTLE, WA 98133-8401
(877) 694-4677
Mailing address
14510 38TH AVE W, LYNNWOOD, WA 98087-5390
(425) 305-9007
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN60948690
WA
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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