Healthcare Provider Details

I. General information

NPI: 1457186835
Provider Name (Legal Business Name): HUSSEIN MAINGWA MBERWA ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32429 50TH CT SW
FEDERAL WAY WA
98023-1918
US

IV. Provider business mailing address

32429 50TH CT SW
FEDERAL WAY WA
98023-1918
US

V. Phone/Fax

Practice location:
  • Phone: 315-418-5535
  • Fax:
Mailing address:
  • Phone: 315-418-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberAP61603769
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61603769
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: