Healthcare Provider Details

I. General information

NPI: 1386364305
Provider Name (Legal Business Name): SYLVIA NDUNGU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 CENTRAL AVE S STE 203
KENT WA
98032-7430
US

IV. Provider business mailing address

7601 89TH AVE SW
LAKEWOOD WA
98498-4917
US

V. Phone/Fax

Practice location:
  • Phone: 888-867-0204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70103669
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number61055275
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: