Provider Demographics
NPI:1699425561
Name:KEMBOI, DENNIS KIPCHIRCHIR (NAR, HCA)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:KIPCHIRCHIR
Last Name:KEMBOI
Suffix:
Gender:M
Credentials:NAR, HCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W CASINO RD APT W105
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-1698
Mailing Address - Country:US
Mailing Address - Phone:206-769-4802
Mailing Address - Fax:
Practice Address - Street 1:702 W CASINO RD APT W105
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-1698
Practice Address - Country:US
Practice Address - Phone:206-769-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANA.60986585376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide