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General NPI Number Information
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NPI Number | 1457994741
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Entity Type | Individual
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Provider Name | KEVIN JOSEPH WANJOHI
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Gender | Male
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Dates
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Enumeration Date | 10/19/2019
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Last Update Date | 10/19/2019
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Provider Practice Location Address
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Address Line | 402 S 333RD ST STE 104
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7099
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Country | US
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Telephone | 206-428-8435
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Fax | 206-374-3026
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Provider Business Mailing Address
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Address Line | 402 S 333RD ST STE 104
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7099
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Country | US
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Telephone | 206-428-8435
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Fax | 206-374-3026
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | WA
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