Healthcare Provider Details

I. General information

NPI: 1588528871
Provider Name (Legal Business Name): DALIN PANIA IMAIKALANI CYRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 NE 124TH ST
SEATTLE WA
98125-5150
US

IV. Provider business mailing address

1706 NE 124TH ST
SEATTLE WA
98125-5150
US

V. Phone/Fax

Practice location:
  • Phone: 801-638-8885
  • Fax:
Mailing address:
  • Phone: 801-638-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN61130842
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: