MEDICARE: SOPHIA NJERI MUIRURI RN

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	163W00000X	Registered Nurse	60726803	WA

General Provider Information

NPI Number	:	1790200301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA NJERI MUIRURI RN

Provider Business Mailing Address
First Line	:	1606 S 253RD PL
Second Line	:
City	:	DES MOINES
State	:	WA
Zip	:	98198-7820
Country	:	US
Telephone Number	:	206-489-7153
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 S 253RD PL
Second Line	:
City	:	DES MOINES
State	:	WA
Zip	:	98198-7820
Country	:	US
Telephone Number	:	206-489-7153
Fax Number	:

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

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	07/21/2022

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