Provider Demographics
NPI:1831603851
Name:KUYENGA, MINZA CHEYO (NA)
Entity type:Individual
Prefix:
First Name:MINZA
Middle Name:CHEYO
Last Name:KUYENGA
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:MINZA
Other - Middle Name:ISAACK
Other - Last Name:CHEYO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NA
Mailing Address - Street 1:14020 176TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-9294
Mailing Address - Country:US
Mailing Address - Phone:206-816-5175
Mailing Address - Fax:
Practice Address - Street 1:14020 176TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-9294
Practice Address - Country:US
Practice Address - Phone:206-816-5175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health