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General NPI Number Information
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NPI Number | 1366310807
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Entity Type | Organization
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Legal Business Name | PEMA CARE HOME
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 10215 OAK LN SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-1743
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Country | US
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Telephone | 253-352-0681
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Fax | 253-352-0681
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Provider Business Mailing Address
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Address Line | 10215 OAK LN SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-1743
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Country | US
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Telephone |
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Fax | 253-352-0681
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Authorized Official
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Title or Position | CAREGIVER
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Name | JOSEPH MWANGI
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Credential |
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Telephone | 253-226-2218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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