Provider Demographics
NPI:1083427009
Name:GICHUKI, GEORGE WACHIRA
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:WACHIRA
Last Name:GICHUKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3732 W OLYMPIC AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6022
Mailing Address - Country:US
Mailing Address - Phone:509-863-9925
Mailing Address - Fax:509-463-7678
Practice Address - Street 1:3732 W OLYMPIC AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6022
Practice Address - Country:US
Practice Address - Phone:509-863-9925
Practice Address - Fax:509-463-7678
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61035936376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide