Healthcare Provider Details

I. General information

NPI: 1609787068
Provider Name (Legal Business Name): OHANA PRIMARY&WOUND CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 BRIDGEPORT WAY W STE B
UNIVERSITY PLACE WA
98466-4330
US

IV. Provider business mailing address

4007 BRIDGEPORT WAY W STE B
UNIVERSITY PLACE WA
98466-4330
US

V. Phone/Fax

Practice location:
  • Phone: 206-636-3239
  • Fax:
Mailing address:
  • Phone: 206-636-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PRISCILLAH W MUIGAI
Title or Position: NP
Credential: FNP-BC
Phone: 517-414-5428