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Individual

VIVIAN CHIZOBA NKWONTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
16251 SYLVESTER RD SW, BURIEN, WA 98166-3017
(253) 426-6341
(253) 858-5436
Mailing address
16251 SYLVESTER RD SW, BURIEN, WA 98166-3017
(253) 426-6341
(253) 858-5436

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57-010767
OH
207R00000X
Internal Medicine Physician
Primary
MD60034300
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0250081
STATE L&I
WA
05
1092206
WA
Enumeration date
05/29/2007
Last updated
12/08/2020
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