Provider Demographics
NPI:1164072476
Name:CAKPO, NIYAFATH ORNELLA
Entity Type:Individual
Prefix:
First Name:NIYAFATH
Middle Name:ORNELLA
Last Name:CAKPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3438 S 148TH ST
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4319
Mailing Address - Country:US
Mailing Address - Phone:206-490-0865
Mailing Address - Fax:
Practice Address - Street 1:3438 S 148TH ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4319
Practice Address - Country:US
Practice Address - Phone:206-490-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WACG61005718101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program