=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497524888
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHIGOZIE EMMANUEL KALU
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2023
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 510 W 1ST AVE
-----------------------------------------------------
City | TOPPENISH
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98948-1564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-865-5600
-----------------------------------------------------
Fax | 509-865-5783
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 190
-----------------------------------------------------
City | TOPPENISH
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98948-0190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-865-2395
-----------------------------------------------------
Fax | 509-865-7057
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN70002699
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP029076
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | AP70005484
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------