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General NPI Number Information
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NPI Number | 1346152634
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Entity Type | Individual
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Provider Name | KELVIN GATHERU WAMAITHA
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Gender | Male
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 3436 MARY ELDER RD NE
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City | OLYMPIA
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State | WA
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Zip | 98506-5050
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Country | US
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Telephone | 360-528-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 6207 72ND AVENUE CT W APT 307
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98467-4752
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CAAR.CG.70127264
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License Number State | WA
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