Provider Demographics
NPI:1306672597
Name:MWAWASI, RUTH M (RN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:M
Last Name:MWAWASI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5216 S 142ND ST
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-4462
Mailing Address - Country:US
Mailing Address - Phone:574-386-1748
Mailing Address - Fax:
Practice Address - Street 1:5216 S 142ND ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4462
Practice Address - Country:US
Practice Address - Phone:574-386-1748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61397330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse