Provider Demographics
NPI:1295502060
Name:OKOLIE, CHUKWUDI VICTOR (APN)
Entity type:Individual
Prefix:MR
First Name:CHUKWUDI
Middle Name:VICTOR
Last Name:OKOLIE
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 PACIFIC AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4437
Mailing Address - Country:US
Mailing Address - Phone:253-844-4327
Mailing Address - Fax:
Practice Address - Street 1:3020 S UNION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-3317
Practice Address - Country:US
Practice Address - Phone:253-844-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14971100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health