Provider Demographics
NPI:1104454925
Name:UKPE, ITORO AKPAN
Entity type:Individual
Prefix:
First Name:ITORO
Middle Name:AKPAN
Last Name:UKPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6852 MONTEVISTA DR SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8223
Mailing Address - Country:US
Mailing Address - Phone:713-478-0510
Mailing Address - Fax:
Practice Address - Street 1:6852 MONTEVISTA DR SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8223
Practice Address - Country:US
Practice Address - Phone:713-478-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies