Individual
BENARD KOSGEI CHESSUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14821 18TH AVE E, TACOMA, WA 98445-3477
(612) 406-0088
Mailing address
14821 18TH AVE E, TACOMA, WA 98445-3477
(612) 406-0088
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60898587
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61484384
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2022
Last updated
10/18/2023
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