Healthcare Provider Details

I. General information

NPI: 1205310679
Provider Name (Legal Business Name): MISS KRISTEN IKENA KAMAKELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 STEWART ST STE 300
SEATTLE WA
98101-1257
US

IV. Provider business mailing address

9520 RAINIER AVE S APT 402
SEATTLE WA
98118-6084
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 808-351-8690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61432671
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-65725
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: