Healthcare Provider Details

I. General information

NPI: 1467816538
Provider Name (Legal Business Name): KENDRA MALIA HO CHING NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA MALIA NIUMATALOLO NP-C

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 UNIVERSITY WAY NE
SEATTLE WA
98105-4511
US

IV. Provider business mailing address

1455 NW IRVING ST STE 600
PORTLAND OR
97209-2277
US

V. Phone/Fax

Practice location:
  • Phone: 844-966-6777
  • Fax: 866-859-8195
Mailing address:
  • Phone: 808-277-7647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2094
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60889509
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number77173
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: