Healthcare Provider Details

I. General information

NPI: 1154231280
Provider Name (Legal Business Name): RAHAB N MUNJUA-MUTHANDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2150 FREEMAN RD E STE 1
FIFE WA
98424-3776
US

IV. Provider business mailing address

11361 N 99TH AVE STE 402
PEORIA AZ
85345-5459
US

V. Phone/Fax

Practice location:
  • Phone: 253-922-7833
  • Fax:
Mailing address:
  • Phone: 602-650-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.RN.61464758
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: