Provider Demographics
NPI:1316810047
Name:MUGAMBI, DENNIS MWITI
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:MWITI
Last Name:MUGAMBI
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 1:719 S SHERIDAN AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3672
Mailing Address - Country:US
Mailing Address - Phone:469-803-0445
Mailing Address - Fax:
Practice Address - Street 1:719 S SHERIDAN AVE UNIT 3
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3672
Practice Address - Country:US
Practice Address - Phone:469-803-0445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX929461163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty