Healthcare Provider Details

I. General information

NPI: 1235066176
Provider Name (Legal Business Name): MARY WANGUI KIIRU-KAMAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4836 S 322ND ST
AUBURN WA
98001-4502
US

IV. Provider business mailing address

4836 S 322ND ST
AUBURN WA
98001-4502
US

V. Phone/Fax

Practice location:
  • Phone: 253-335-6451
  • Fax: 253-251-0676
Mailing address:
  • Phone: 253-335-6451
  • Fax: 253-251-0676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN70010320
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: