Provider Demographics
NPI:1598437683
Name:KHIEV, KANITHA
Entity Type:Individual
Prefix:
First Name:KANITHA
Middle Name:
Last Name:KHIEV
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 1:11829 SE 228TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-3717
Mailing Address - Country:US
Mailing Address - Phone:206-375-9907
Mailing Address - Fax:
Practice Address - Street 1:11829 SE 228TH PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-3717
Practice Address - Country:US
Practice Address - Phone:206-375-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61098100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse