Healthcare Provider Details

I. General information

NPI: 1407570740
Provider Name (Legal Business Name): EMILY NGINA NJAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 10TH ST SE UNIT B
PUYALLUP WA
98372-3359
US

IV. Provider business mailing address

620 10TH ST SE UNIT B
PUYALLUP WA
98372-3359
US

V. Phone/Fax

Practice location:
  • Phone: 314-229-3435
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number60869885
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: