Dawda Cham

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP61008322 Issued in WA

Practice address

707 S Grady Way Ste 400
Renton, WA 98057-3227

Phone

(206) 348-8685

Fax

(206) 309-3319

NPI assigned

Nov 20, 2019

Last updated

Aug 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1093351447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573227",
            "telephone_number": "206-348-8685",
            "fax_number": "206-309-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573227",
            "telephone_number": "206-348-8685",
            "fax_number": "206-309-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAM",
        "first_name": "DAWDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61008322",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60092579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan R. Cero, M.D.
• Frank J. Cervenka, M.D.
• Chad Smart DDS and Vincent O Kokich Jr DMD MSD PLLC
• Sumita Chakrapani, M.D.
• Lisa Jo Chalupny, RPH
• Isatou C Cham, RN
• Kristina Lynn Chamberlain, CNM, ARNP
• Doris Chan-Lee
• John Y Chan, RPH
• Ka Yee Chan, ARNP

• Primary Care Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Primary Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.