Provider Demographics
NPI:1053183640
Name:IWUOHA, CHUKWUMA TIMOTHY
Entity type:Individual
Prefix:
First Name:CHUKWUMA
Middle Name:TIMOTHY
Last Name:IWUOHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23609 56TH AVE W APT 306
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5255
Mailing Address - Country:US
Mailing Address - Phone:206-853-0444
Mailing Address - Fax:
Practice Address - Street 1:23609 56TH AVE W APT 306
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5255
Practice Address - Country:US
Practice Address - Phone:206-853-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program