Provider Demographics
NPI:1912715046
Name:BIWOTT, SAMMY (CNA, HEALTHCARE MGT)
Entity type:Individual
Prefix:
First Name:SAMMY
Middle Name:
Last Name:BIWOTT
Suffix:
Gender:M
Credentials:CNA, HEALTHCARE MGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 LARLIN DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-6932
Mailing Address - Country:US
Mailing Address - Phone:425-503-2432
Mailing Address - Fax:
Practice Address - Street 1:2314 LARLIN DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-6932
Practice Address - Country:US
Practice Address - Phone:425-503-2432
Practice Address - Fax:425-405-3622
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60898093376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide