Provider Demographics
NPI:1972896884
Name:NDIRANGU, GRACE W (DC)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:W
Last Name:NDIRANGU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34004 9TH AVE S
Mailing Address - Street 2:STE A9
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6737
Mailing Address - Country:US
Mailing Address - Phone:253-517-8556
Mailing Address - Fax:253-517-8556
Practice Address - Street 1:34004 9TH AVE S
Practice Address - Street 2:STE A9
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6737
Practice Address - Country:US
Practice Address - Phone:253-517-8556
Practice Address - Fax:253-517-8556
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60081656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor