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General NPI Number Information
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NPI Number | 1073291654
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Entity Type | Individual
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Provider Name | JANE GICHUKI
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Gender | Female
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 3623 W INDIAN TRAIL RD
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City | SPOKANE
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State | WA
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Zip | 99208-4733
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Country | US
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Telephone | 509-598-8745
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Fax | 509-357-1308
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Provider Business Mailing Address
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Address Line | 3623 W INDIAN TRAIL RD
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City | SPOKANE
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State | WA
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Zip | 99208-4733
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Country | US
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Telephone | 509-598-8745
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Fax | 509-357-1308
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 60840790
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License Number State | WA
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