Individual provider Active NPI

Princess Amaka Ikemenogo, MD, MSPH

  • Neurology Physician
  • Seattle, WA
National Provider Identifier
1225603897
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
70006606 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-4923
Phone
(206) 543-2340
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 70006606 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-4923

Mailing address

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 543-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610002948 RI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9537569637

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Meharry Medical College School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

707 Ctr St
Suite 110
Columbus, GA 31901-1575

PO Box
Atlanta, GA 30368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70006606WAMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1225603897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981954923",
            "telephone_number": "206-543-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKEMENOGO",
        "first_name": "PRINCESS",
        "middle_name": "AMAKA",
        "name_prefix": "Dr.",
        "credential": "MD, MSPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "70006606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.