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General NPI Number Information
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NPI Number | 1275497430
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Entity Type | Individual
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Provider Name | CHIPILIRO CHISAO NAMELO
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 930 S 336TH ST STE G
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6384
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Country | US
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Telephone | 443-766-5628
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Fax |
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Provider Business Mailing Address
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Address Line | 31914 3RD PL SW APT D
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City | FEDERAL WAY
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State | WA
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Zip | 98023-4695
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Country | US
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Telephone | 443-766-5628
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 61624697
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License Number State | WA
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