Provider Demographics
NPI:1245193697
Name:KINYANJUI, TABITHA WANJIRU
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:WANJIRU
Last Name:KINYANJUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13516 MERIDIAN E UNIT 73613
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-9979
Mailing Address - Country:US
Mailing Address - Phone:253-260-9432
Mailing Address - Fax:
Practice Address - Street 1:13516 MERIDIAN E UNIT 73613
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-9979
Practice Address - Country:US
Practice Address - Phone:253-260-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)