Healthcare Provider Details

I. General information

NPI: 1700571486
Provider Name (Legal Business Name): SAMIA KAY MUNAYIRJI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 NE 20TH AVE STE B200
VANCOUVER WA
98686-6412
US

IV. Provider business mailing address

3707 NE 174TH ST
VANCOUVER WA
98686-1861
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-1985
  • Fax:
Mailing address:
  • Phone: 208-861-7586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.MD.70132313
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: