Basic Information
| Provider Information | |||||||||
| NPI: | 1881288223 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NACHAMPASSAK-AGBAYANI | ||||||||
| FirstName: | DANILE | ||||||||
| MiddleName: | U | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 59TH AVE SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984996600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2536205015 | ||||||||
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| Practice Location | |||||||||
| Address1: | 875 WAIMANU ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085333936 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2021 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.