Healthcare Provider Details

I. General information

NPI: 1952213134
Provider Name (Legal Business Name): LAMIN FOFANA RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3672 SW 318TH ST
FEDERAL WAY WA
98023-2153
US

IV. Provider business mailing address

3672 SW 318TH ST
FEDERAL WAY WA
98023-2153
US

V. Phone/Fax

Practice location:
  • Phone: 425-344-3868
  • Fax:
Mailing address:
  • Phone: 425-344-3867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN6085941
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: