Provider Demographics
NPI:1750656641
Name:AGENA, JOANNA CHOW NGIT (FNP-BC, APRN-RX)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:CHOW NGIT
Last Name:AGENA
Suffix:
Gender:F
Credentials:FNP-BC, APRN-RX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST STE 1500
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1369
Mailing Address - Country:US
Mailing Address - Phone:206-965-1700
Mailing Address - Fax:206-965-1736
Practice Address - Street 1:1101 MADISON ST STE 1500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-965-1700
Practice Address - Fax:206-965-1736
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60865167363L00000X
HI1422363LF0000X
WARN60863760163W00000X
HI384363LF0000X
CA95003785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse