Provider Demographics
NPI:1184923856
Name:ENOS, KHO-HAY AZUL (LMP)
Entity type:Individual
Prefix:
First Name:KHO-HAY
Middle Name:AZUL
Last Name:ENOS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 N RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-9535
Mailing Address - Country:US
Mailing Address - Phone:253-226-7021
Mailing Address - Fax:
Practice Address - Street 1:555 108TH AVE NE STE 1
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5578
Practice Address - Country:US
Practice Address - Phone:425-452-9280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60147179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor