Individual provider Active NPI

Shazzareigh Malialani Nakoa-Chung

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1346960093
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7700 NE Parkway Dr Ste 215
Vancouver, WA 98662-6653
Phone
(360) 953-3199
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

7700 NE Parkway Dr Ste 215
Vancouver, WA 98662-6653

Mailing address

12502 S New Era Rd
Oregon City, OR 97045-9719
Phone (808) 490-4845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Living Pono Mental Health LLC Mental Health CurrentSince Oct 9, 2022 Accepting new patients
Bright Life Therapy LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

7700 NE Parkway Dr
Ste 215
Vancouver, WA 98662
Phone (213) 550-5294

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1346960093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12502 S NEW ERA RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459719",
            "telephone_number": "808-490-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR STE 215",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626653",
            "telephone_number": "360-953-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKOA-CHUNG",
        "first_name": "SHAZZAREIGH",
        "middle_name": "MALIALANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.