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General NPI Number Information
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NPI Number | 1205334927
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Entity Type | Individual
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Provider Name | MARTHA WAHU MBURU RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/28/2018
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 15416 205TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-5568
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Country | US
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Telephone | 574-707-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 15416 205TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-5568
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Country | US
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Telephone | 574-707-5898
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Fax | 253-448-7411
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 61267437
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN61267437
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License Number State | WA
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