NPIMap

Organization Active NPI

Kikalu PLLC

  • Adult Mental Health Clinic/Center
  • Mountlake Terrace, WA
National Provider Identifier
1538851191
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
KIKALU PLLC
Practice address
21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200
Phone
(425) 948-7248
NPI assigned
May 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Mr. Michael Gwanjaye, LSWAICNPI 1013649698
Title
Therapist
Phone
(425) 948-7248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Assisted Living Facility (Mental Illness) 3104A0625X

Addresses

Primary practice location

21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200

Mailing address

14623 Main St Apt B203
Mill Creek, WA 98012-2013
Phone (929) 525-7290

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1538851191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14623 MAIN ST APT B203",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980122013",
            "telephone_number": "929-525-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE W STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980436200",
            "telephone_number": "425-948-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIKALU PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "GWANJAYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "425-948-7248",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSWAIC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.