Provider Demographics
NPI:1073246930
Name:MWANGI, MONICAH WANGARI
Entity type:Individual
Prefix:
First Name:MONICAH
Middle Name:WANGARI
Last Name:MWANGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONICAH
Other - Middle Name:WANGARI
Other - Last Name:NGUGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:105 112TH ST S # 254
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98444-5711
Mailing Address - Country:US
Mailing Address - Phone:253-300-1671
Mailing Address - Fax:
Practice Address - Street 1:105 112TH ST S # 254
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:WA
Practice Address - Zip Code:98444-5711
Practice Address - Country:US
Practice Address - Phone:253-300-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60759926163W00000X
WAAP61455556363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse