Doctor Name: | DR. VANESSA G DZIVAKWE |
NPI Number: | 1013340793 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | |
Business Practice Address: | 818 12th Ave Seattle, WA - 981224410 |
Business Phone Number: | 2063295255 |
Business Fax Number: | 2067261878 |
Mailing Address: | 818 12th Ave, SEATTLE |
State: | WA |
Postal Code: | 981224410 |
Phone Number: | 2063295255 |
Fax Number: | 2067261878 |
NPI Enumeration Date: | 08/16/2013 |
NPI Last Update Date: | 05/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |