Provider Demographics
NPI:1043192016
Name:CHRISTIAN EZEOFOR, CHINONSO
Entity type:Individual
Prefix:
First Name:CHINONSO
Middle Name:
Last Name:CHRISTIAN EZEOFOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 25TH AVE S UNIT 314
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-5320
Mailing Address - Country:US
Mailing Address - Phone:713-382-6817
Mailing Address - Fax:
Practice Address - Street 1:1950 112TH AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2957
Practice Address - Country:US
Practice Address - Phone:713-382-6817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032963163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse