Healthcare Provider Details

I. General information

NPI: 1194639575
Provider Name (Legal Business Name): HADY FLORE MAFEUGANG KOUGANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NORTH DIVISION AUBURN, WA ST SUITE 201 (PLAZA TWO)
AUBURN WA
98001
US

IV. Provider business mailing address

202 N DIVISION ST STE 201
AUBURN WA
98001-4939
US

V. Phone/Fax

Practice location:
  • Phone: 253-572-7320
  • Fax:
Mailing address:
  • Phone: 253-572-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberBJKBJKBKJBJNB
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: