Provider Demographics
NPI:1962362905
Name:IMATHIU, LAWI GITONGA
Entity type:Individual
Prefix:MR
First Name:LAWI
Middle Name:GITONGA
Last Name:IMATHIU
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 1:32820 20TH AVE S UNIT 63
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-9433
Mailing Address - Country:US
Mailing Address - Phone:540-589-0655
Mailing Address - Fax:
Practice Address - Street 1:748 MARKET ST # 157
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3737
Practice Address - Country:US
Practice Address - Phone:253-235-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACBT.CB.70056975106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician