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General NPI Number Information
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NPI Number | 1578333589
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Entity Type | Individual
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Provider Name | MICHAEL NYASANI KINGOINA ARNP
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Gender | Male
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Dates
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Enumeration Date | 01/02/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2150 N 107TH ST STE 480
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City | SEATTLE
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State | WA
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Zip | 98133-9009
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Country | US
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Telephone | 866-686-2504
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Fax |
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Provider Business Mailing Address
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Address Line | 20804 77TH ST E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-8766
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Country | US
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Telephone | 425-269-5016
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61512716
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License Number State | WA
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