Healthcare Provider Details

I. General information

NPI: 1710899802
Provider Name (Legal Business Name): SILVIAH WANJIRU GATHUA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW HOLDEN ST
SEATTLE WA
98126-3505
US

IV. Provider business mailing address

2600 SW HOLDEN ST
SEATTLE WA
98126-3505
US

V. Phone/Fax

Practice location:
  • Phone: 636-352-3607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberNAR.NA.61624647
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: