Healthcare Provider Details

I. General information

NPI: 1750902284
Provider Name (Legal Business Name): CAROL GIJIMA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33455 6TH AVE S STE 2C
FEDERAL WAY WA
98003-6074
US

IV. Provider business mailing address

19932 20TH AVENUE CT E
SPANAWAY WA
98387-4108
US

V. Phone/Fax

Practice location:
  • Phone: 253-367-0502
  • Fax:
Mailing address:
  • Phone: 253-217-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70163790-NP
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60400511
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: