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General NPI Number Information
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NPI Number | 1659066942
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Entity Type | Individual
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Provider Name | ROBINSON MBUGUA
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Gender | Male
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 7208 205TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-6123
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Country | US
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Telephone | 253-985-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 7208 205TH AVE E
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City | BONNEY LAKE
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State | WA
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Zip | 98391-6123
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Country | US
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Telephone | 253-985-1071
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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