Healthcare Provider Details

I. General information

NPI: 1194336602
Provider Name (Legal Business Name): TAPUWA L. CHIKWINYA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 11/27/2023
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6004 WESTGATE BLVD STE 180
TACOMA WA
98406-2503
US

IV. Provider business mailing address

4914 N 11TH ST
TACOMA WA
98406-3110
US

V. Phone/Fax

Practice location:
  • Phone: 253-205-0873
  • Fax:
Mailing address:
  • Phone: 253-583-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. TAPUWA LAMOORE CHIKWINYA
Title or Position: OWNER
Credential: OD
Phone: 253-583-4232