Provider Demographics
NPI:1215676762
Name:NJUGUNA, RAYMOND MBURU
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:MBURU
Last Name:NJUGUNA
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 1:275 W VINE ST
Mailing Address - Street 2:
Mailing Address - City:NAPAVINE
Mailing Address - State:WA
Mailing Address - Zip Code:98532-7641
Mailing Address - Country:US
Mailing Address - Phone:732-642-9149
Mailing Address - Fax:
Practice Address - Street 1:275 W VINE ST
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98532-7641
Practice Address - Country:US
Practice Address - Phone:732-642-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60928463376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide