Provider Demographics
NPI:1821813353
Name:KANIKE, AGNESS NAMUKIE (CNA)
Entity type:Individual
Prefix:
First Name:AGNESS
Middle Name:NAMUKIE
Last Name:KANIKE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30823 18TH AVE S APT B302
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4986
Mailing Address - Country:US
Mailing Address - Phone:425-931-3207
Mailing Address - Fax:
Practice Address - Street 1:3512 ALBION PL N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8875
Practice Address - Country:US
Practice Address - Phone:206-901-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor