MEDICARE: THERESE NJOKA

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	183500000X	Pharmacist	61035657	WA

General Provider Information

NPI Number	:	1336721372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESE NJOKA

Provider Business Mailing Address
First Line	:	27752 MAPLE RIDGE WAY SE
Second Line	:
City	:	MAPLE VALLEY
State	:	WA
Zip	:	98038-2009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27752 MAPLE RIDGE WAY SE
Second Line	:
City	:	MAPLE VALLEY
State	:	WA
Zip	:	98038-2009
Country	:	US
Telephone Number	:	859-801-9218
Fax Number	:

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

Provider Enumeration Date	:	04/28/2021
Last Update Date	:	04/28/2021

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Directions to “ THERESE NJOKA ” Practice Location

Language	Start Address	Practice Location

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