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General NPI Number Information
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NPI Number | 1740050749
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Entity Type | Individual
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Provider Name | JOHN KIMATHI GIKUNDA
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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 | 01/02/2024
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Provider Practice Location Address
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Address Line | 402 NJ ST TACOMA 98403 HOUSE
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City | TACOMA
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State | WA
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Zip | 98403
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Country | US
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Telephone | 206-214-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 S HOSMER ST APT E15
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City | TACOMA
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State | WA
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Zip | 98444-6876
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Country | US
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Telephone | 206-571-3881
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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