Provider Demographics
NPI:1619401668
Name:KWENDAKWEMA, CHIPO NATASHA (MD)
Entity Type:Individual
Prefix:
First Name:CHIPO
Middle Name:NATASHA
Last Name:KWENDAKWEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST RM BB-527
Mailing Address - Street 2:BOX 356421
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6421
Mailing Address - Country:US
Mailing Address - Phone:801-860-7977
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST RM BB527
Practice Address - Street 2:BOX 356421
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6421
Practice Address - Country:US
Practice Address - Phone:801-860-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60977607208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine