Provider Demographics
NPI:1720744667
Name:KUKUIA CARE
Entity Type:Organization
Organization Name:KUKUIA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUKUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-251-2054
Mailing Address - Street 1:1712 6TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3300
Mailing Address - Country:US
Mailing Address - Phone:206-259-3338
Mailing Address - Fax:253-366-7283
Practice Address - Street 1:1712 6TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3300
Practice Address - Country:US
Practice Address - Phone:206-259-3338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care