Organization
KIKALU PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GWANJAYE LSWAIC (THERAPIST)
(425) 948-7248
Entity
Organization
Contact information
Practice address
21907 64TH AVE W STE 200, MOUNTLAKE TERRACE, WA 98043-6200
(425) 948-7248
Mailing address
14623 MAIN ST APT B203, MILL CREEK, WA 98012-2013
(929) 525-7290
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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