Healthcare Provider Details

I. General information

NPI: 1629944624
Provider Name (Legal Business Name): SUSAN NJOROGE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 NE 12TH ST
RENTON WA
98056-2846
US

IV. Provider business mailing address

350 SHADOW AVE NE
RENTON WA
98059-4651
US

V. Phone/Fax

Practice location:
  • Phone: 425-336-2700
  • Fax: 425-336-2699
Mailing address:
  • Phone: 206-397-7147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60642478
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: