Provider Demographics
NPI:1376304485
Name:CHIKKAVEERAIAH, AKASH
Entity Type:Individual
Prefix:MR
First Name:AKASH
Middle Name:
Last Name:CHIKKAVEERAIAH
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 1:9318 57TH AVENUE CT SW APT K203
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-7389
Mailing Address - Country:US
Mailing Address - Phone:951-386-9807
Mailing Address - Fax:
Practice Address - Street 1:10501 47TH AVE SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3712
Practice Address - Country:US
Practice Address - Phone:253-583-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI61487538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist