Provider Demographics
NPI:1407659550
Name:PERKINS, INDINA SHADE
Entity type:Individual
Prefix:
First Name:INDINA
Middle Name:SHADE
Last Name:PERKINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24015 110TH PL SE APT Q201
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-5368
Mailing Address - Country:US
Mailing Address - Phone:206-849-6044
Mailing Address - Fax:
Practice Address - Street 1:24015 110TH PL SE APT Q201
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-5368
Practice Address - Country:US
Practice Address - Phone:206-849-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator