MEDICARE: ROSE N MULWA NA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	NC61276168	WA

General Provider Information

NPI Number	:	1205606019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE N MULWA NA

Provider Business Mailing Address
First Line	:	9400 RAINIER
Second Line	:	9400 RAINIER AVE SOUTH APT 459
City	:	SEATTLE
State	:	WA
Zip	:	98118
Country	:	US
Telephone Number	:	125-331-6057
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 RAINIER
Second Line	:	9400 RAINIER AVE SOUTH APT 459
City	:	SEATTLE
State	:	WA
Zip	:	98118
Country	:	US
Telephone Number	:	125-331-6057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	01/03/2024

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Directions to “ ROSE N MULWA NA” Practice Location

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