Provider Demographics
NPI:1346960093
Name:NAKOA-CHUNG, SHAZZAREIGH MALIALANI
Entity Type:Individual
Prefix:
First Name:SHAZZAREIGH
Middle Name:MALIALANI
Last Name:NAKOA-CHUNG
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 1:12502 S NEW ERA RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-9719
Mailing Address - Country:US
Mailing Address - Phone:808-490-4845
Mailing Address - Fax:
Practice Address - Street 1:7700 NE PARKWAY DR STE 215
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6653
Practice Address - Country:US
Practice Address - Phone:360-953-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health