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General NPI Number Information
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NPI Number | 1043882434
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Entity Type | Individual
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Provider Name | MRS. NIKHILA POKKULURI
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Gender | Female
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 9100 BRIDGEPORT WAY SE
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City | LAKEWOOD
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State | WA
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Zip | 98499
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Country | US
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Telephone | 253-302-3826
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Fax | 206-901-2010
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Provider Business Mailing Address
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Address Line | 9100 BRIDGEPORT WAY SE
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City | LAKEWOOD
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State | WA
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Zip | 98499
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Country | US
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Telephone | 781-526-8595
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Fax | 206-901-2010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1043882434
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License Number State | WA
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